Systematic Review and Meta‐Analysis on Neuropsychological Effects of Long‐Term Use of Opioids in Patients With Chronic Noncancer Pain

@article{Allegri2019SystematicRA,
  title={Systematic Review and Meta‐Analysis on Neuropsychological Effects of Long‐Term Use of Opioids in Patients With Chronic Noncancer Pain},
  author={Nicola Allegri and Simona Mennuni and Eliana Rulli and Nicola Vanacore and Oscar Corli and Irene C Floriani and Irene De Simone and Massimo Allegri and Stefano Govoni and Tomaso Vecchi and Giorgio Sandrini and Davide Liccione and Elena Biagioli},
  journal={Pain Practice},
  year={2019},
  volume={19}
}
Opioid treatments are often prolonged because of the pathology causing pain. We focused on the cognitive functions in patients with chronic pain treated with opioids. This topic is currently controversial, but in practice, the consequences are important in patients’ daily lives, social interactions, working ability, and driving. 
Patients’ self‐reported physical and psychological effects of opioid use in chronic noncancer pain—A retrospective cross‐sectional analysis
TLDR
This study aims to identify and measure the nature and frequency of physical and psychological effects and the degree of physician counseling of patients with CNCP taking strong opioids.
Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study
TLDR
Cognitive function showed minor improvement after opioid tapering with stationary health-related quality of life, depression and anxiety scores, and the clinical significance is unclear, as no minimal clinically important difference in RBANS score is available.
Comparison of the Impacts of Under-Treated Pain and Opioid Pain Medication on Cognitive Impairment
TLDR
The published literature indicates that moderate to severe pain can impair cognitive function, and that careful use of opioid analgesics in such subjects does not necessarily worsen cognition.
Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder
TLDR
Rotation to BuNa in patients with CNCP and OUD was accompanied by reductions in opioid misuse, opioid craving, the severity of co-occurring psychiatric symptoms, and self-reported pain, which underline the need for the replication of the current findings in large-scale, controlled studies.
Tramadol prescribed use in general and chronic noncancer pain: a nationwide register-based cohort study of all patients above 16 years
TLDR
This study proved a widespread prescribed use of tramadol in Denmark, and, as know from the literature, weak opioid use may lead to long-term use of high potent opioids, this usage is inappropriate, in general, but especially for the treatment of CNCP.
Incident Functional Limitations Among Community-Dwelling Adults Using Opioids: A Retrospective Cohort Study Using a Propensity Analysis with the Health and Retirement Study
TLDR
Middle-aged adults, compared with those older than 65 years of age, experienced the greatest odds for incident ADL and IADL limitations following opioid use, suggesting community-dwelling adults using opioid analgesics to manage pain may be at risk for incident AdL limitations.
Combined Effects of Pain Interference and Depressive Symptoms on Dementia Incidence: A 36-Month Follow-Up Study.
TLDR
The coexistence of pain interference and depressive symptoms had a greater effect on the incidence of dementia than either condition alone in community-dwelling elderly individuals.
The association between pain type, cognition and complaint after mild traumatic brain injury in prospectively studied premorbidly healthy adults admitted to hospital.
TLDR
These findings show for the first time that it is important to examine both affective and sensory aspects of pain in individuals after mTBI, as pain subtypes show differential relationships with cognition.
Conflicts of interest among authors of systematic reviews regarding the management of chronic non-cancer pain with opioids analgesics.
TLDR
COI are common and frequently undisclosed among systematic review authors investigating opioid analgesics for the management of chronic non-cancer pain, and despite a high prevalence of COI, it was found that these author-industry relationships had a significant influence on the favorability of results and conclusions.
...
...

References

SHOWING 1-10 OF 123 REFERENCES
Cognitive function in patients with chronic pain treated with opioids: characteristics and associated factors
The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess
Assessing cognition and psychomotor function under long‐term treatment with controlled release oxycodone in non‐cancer pain patients
TLDR
No data exist about the effect of long‐term treatment with controlled release oxycodone (CRO) on driving ability, but the therapeutic use of opioids can be associated with altered cognition and impaired psychomotor function.
Evidence of specific cognitive deficits in patients with chronic low back pain under long-term substitution treatment of opioids.
TLDR
The cognitive functions of patients with chronic back pain who underwent long-term opioid treatment in comparison with those patients without opioid usage and healthy controls were investigated to give a differential view into the cognitive changes from Chronic back pain with and without long- term opioids treatment.
A Review of the Effects of Opioids on Psychomotor and Cognitive Functioning in Humans
TLDR
The literature on the effects of opioids on psychomotor and cognitive functioning in humans is evaluated and the acute and chronic effects of various opioids on different subject populations are examined.
Effects of Intermediate- and Long-Term Use of Opioids on Cognition in Patients With Chronic Pain
The authors review research on the intermediate- and long-term effects of taking opioid medication on cognitive functioning in patients with chronic cancer and non-cancer pain. Opioids seem to be
Cognitive effects of opioids
  • S. Strassels
  • Psychology, Biology
    Current pain and headache reports
  • 2008
TLDR
Current evidence indicates that cognitive function can be influenced by use of opioid analgesics, although the effects vary between drugs, and are thought to be most significant with mixed-activity drugs, codeine, propoxyphene, and meperidine.
Neuropsychological effects of long-term opioid use in chronic pain patients.
Cognitive Effects and Sedation.
TLDR
CES is prevalent in chronic nonmalignant pain populations receiving long-term opioid therapy and are among the most common reasons patients discontinue opioid use, particularly among the elderly.
...
...