McMaster University

Michael G. DeGroote
National Pain Centre

Scope of Search

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain

7. Epidemiology of Chronic Non-Cancer Pain (CNCP)

Chronic Non-cancer Pain (CNCP) is a major problem in modern society. The negative effects on quality of life and productivity have an immense social and economic impact.

Chronic pain in persons older than 65 years of age is a significant problem for Canada. A recently published study (Ramage-Morin 2009) used data from 1) the Health Institutions and Household components of the "National Population Health Survey" (NPHS; Statistics Canada 1994/1995 through 2002/2003) and 2) the 2005 "Canadian Community Health Survey" (CCHS). Thirty-eight percent of institutionalized seniors experienced pain on a regular basis, compared with 27% of seniors living in households. In both populations, rates were higher for women than men. Given the fact that Canada’s population is aging, chronic pain promises to become an even larger problem in the near future.

Osteoarthritis affects 3 million (1 in 10) Canadians. It affects men and women in equal numbers. Most people develop osteoarthritis after the age of 45, but it can occur at any age (www.arthritis.ca).

The Canadian Pain Society (CPS) has suggested that up to 1 million Canadians live with neuropathic pain (Moulin 2007). This is based on an estimate of the prevalence of 8.2% chronic neuropathic pain in the general population (Torrance 2006).

The "Canadian Chronic Pain Study II" (CCPS-II) was set to study the prevalence of chronic pain by conducting a general population computer-assisted telephone interview. The response rate was only 20%, and they found the prevalence of chronic pain to be 25% of the respondents (Boulanger 2007). In comparison with the CCPS-I, the prevalence of chronic pain was 29% in 2001.

Low-back pain is among the most common causes of CNCP, and there are no studies conducted in Canada to examine its prevalence. A recent national survey conducted in the United States showed that 15% reported "back pain on most days for at least one month in the past year" (Ricci 2006).

In a United Kingdom study, 46.5% of the general population reported chronic pain; low-back problems and arthritis were the leading causes (Elliott 1999).

A recent epidemiological study in Denmark found that CNCP had a prevalence of 19%, and 12% of those who had CNCP (corresponding to 130,000 adults or 3% of Denmark’s population) used opioid medications regularly (Eriksen 2004).

It is reasonable to conclude that CNCP affects substantial and growing numbers of the Canadian population. Not all treatment approaches have been well studied, but opioids are a modality that has been shown to be effective in reducing intensity of pain in many of these chronic pain conditions.