<sod>Opioids are being used more frequently in the management of non-malignant [[chronic pain]].<ref>{{cite journal | pmid = 22786464 | volume=15 | issue=3 Suppl | title=Opioid epidemic in the United States. | date=Jul 2012 | journal=Pain Physician | pages=ES9-38}}</ref><ref>http://www.jpain.org/article/S1526-5900(08)00830-4/abstract</ref><ref>{{cite web|url=http://www.painjournalonline.com/article/S0304-3959(06)00316-2/abstract |title=PAIN |publisher=Painjournalonline.com |date=2015-09-01 |accessdate=2016-01-07}}</ref> This practice has now led to a new and growing problem with addiction and misuse of opioids.<ref name="Okie S (2010)"/><ref>{{cite web|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712997/ |title=Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety? |publisher=Ncbi.nlm.nih.gov |date=2015-09-28 |accessdate=2016-01-07}}</ref> Because of various negative effects the use of opioids for long term management of chronic pain is not indicated unless other less risky pain relievers have been found ineffective. Chronic pain which occurs only periodically, such as that from [[nerve pain]], [[migraines]], and [[fibromyalgia]], frequently is better treated with drugs other than opioids.<ref name="AANfive" /> [[Paracetamol]] and [[non-steroidal anti-inflammatory drugs]] including [[ibuprofen]] and [[naproxen]] are considered safer alternatives.<ref>{{Cite journal| last = Dhalla| first = Irfan A.| last2 = Gomes| first2 = Tara| last3 = Mamdani| first3 = Muhammad M.| last4 = Juurlink| first4 = David N.| date = 2012| title = Opioids versus nonsteroidal anti-inflammatory drugs in noncancer pain| url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264005/| journal = Canadian Family Physician| volume = 58| issue = 1| pages = 30| issn = 0008-350X| pmc = 3264005| pmid = 22267615}}</ref> They are frequently used combined with opioids, such as paracetamol combined with [[oxycodone]] ([[Oxycodone/paracetamol|Percocet]]) and ibuprofen combined with [[hydrocodone]] ([[Hydrocodone/ibuprofen|Vicoprofen]]), which [[Synergy|boosts the pain relief]] but is also intended to deter recreational use.<ref>{{Cite journal| last = Marret| first = E.| last2 = Beloeil| first2 = H.| last3 = Lejus| first3 = C.| date = 2009| title = [What are the benefits and risk of non-opioid analgesics combined with postoperative opioids?]| url = http://www.ncbi.nlm.nih.gov/pubmed/19304445| journal = Annales Françaises D'anesthèsie Et De Rèanimation| volume = 28| issue = 3| pages = e135–151| doi = 10.1016/j.annfar.2009.01.006| issn = 1769-6623| pmid = 19304445}}</ref><ref>{{Cite journal| last = Franceschi| first = F.| last2 = Iacomini| first2 = P.| last3 = Marsiliani| first3 = D.| last4 = Cordischi| first4 = C.| last5 = Antonini| first5 = E. Forte S.| last6 = Alesi| first6 = A.| last7 = Giacobelli| first7 = D.| last8 = Zuccalà| first8 = G.| date = 2013| title = Safety and efficacy of the combination acetaminophen-codeine in the treatment of pain of different origin| url = http://www.europeanreview.org/wp/wp-content/uploads/2129-2135.pdf| format = pdf| journal = European Review for Medical and Pharmacological Sciences| volume = 17| issue = 16| pages = 2129–2135| issn = 1128-3602| pmid = 23893177}}</ref><eod>
<sod>Opioids are being used more frequently in the management of non-malignant [[chronic pain]].<ref>{{cite journal | pmid = 22786464 | volume=15 | issue=3 Suppl | title=Opioid epidemic in the United States. | date=Jul 2012 | journal=Pain Physician | pages=ES9-38}}</ref><ref>http://www.jpain.org/article/S1526-5900(08)00830-4/abstract</ref><ref>{{cite web|url=http://www.painjournalonline.com/article/S0304-3959(06)00316-2/abstract |title=PAIN |publisher=Painjournalonline.com |date=2015-09-01 |accessdate=2016-01-07}}</ref> This practice has now led to a new and growing problem with addiction and misuse of opioids.<ref name="Okie S (2010)"/><ref>{{cite web|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712997/ |title=Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety? |publisher=Ncbi.nlm.nih.gov |date=2015-09-28 |accessdate=2016-01-07}}</ref> Because of various negative effects the use of opioids for long term management of chronic pain is not indicated unless other less risky pain relievers have been found ineffective. Chronic pain which occurs only periodically, such as that from [[nerve pain]], [[migraines]], and [[fibromyalgia]], frequently is better treated with medications other than opioids.<ref name="AANfive" /> [[Paracetamol]] and [[non-steroidal anti-inflammatory drugs]] including [[ibuprofen]] and [[naproxen]] are considered safer alternatives.<ref>{{Cite journal| last = Dhalla| first = Irfan A.| last2 = Gomes| first2 = Tara| last3 = Mamdani| first3 = Muhammad M.| last4 = Juurlink| first4 = David N.| date = 2012| title = Opioids versus nonsteroidal anti-inflammatory drugs in noncancer pain| url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264005/| journal = Canadian Family Physician| volume = 58| issue = 1| pages = 30| issn = 0008-350X| pmc = 3264005| pmid = 22267615}}</ref> They are frequently used combined with opioids, such as paracetamol combined with [[oxycodone]] ([[Oxycodone/paracetamol|Percocet]]) and ibuprofen combined with [[hydrocodone]] ([[Hydrocodone/ibuprofen|Vicoprofen]]), which [[Synergy|boosts the pain relief]] but is also intended to deter recreational use.<ref>{{Cite journal| last = Marret| first = E.| last2 = Beloeil| first2 = H.| last3 = Lejus| first3 = C.| date = 2009| title = [What are the benefits and risk of non-opioid analgesics combined with postoperative opioids?]| url = http://www.ncbi.nlm.nih.gov/pubmed/19304445| journal = Annales Françaises D'anesthèsie Et De Rèanimation| volume = 28| issue = 3| pages = e135–151| doi = 10.1016/j.annfar.2009.01.006| issn = 1769-6623| pmid = 19304445}}</ref><ref>{{Cite journal| last = Franceschi| first = F.| last2 = Iacomini| first2 = P.| last3 = Marsiliani| first3 = D.| last4 = Cordischi| first4 = C.| last5 = Antonini| first5 = E. Forte S.| last6 = Alesi| first6 = A.| last7 = Giacobelli| first7 = D.| last8 = Zuccalà| first8 = G.| date = 2013| title = Safety and efficacy of the combination acetaminophen-codeine in the treatment of pain of different origin| url = http://www.europeanreview.org/wp/wp-content/uploads/2129-2135.pdf| format = pdf| journal = European Review for Medical and Pharmacological Sciences| volume = 17| issue = 16| pages = 2129–2135| issn = 1128-3602| pmid = 23893177}}</ref><eod>