Chou R, Deyo R, Friedly J, et al. Noninvasive treatments for low back pain [internet]. AHRQ Comparative Effectiveness Reviews. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Feb. Report No 16-EHC004-EF. Article

Reddy S, Patt RB. The benzodiazepines as adjuvant analgesics. J Pain Symptom Manage. 1994;9(8):510-4. Abstract

Guidelines

American Academy of Neurology 2016 Evidence-Based Guideline: Treatment of Painful Diabetic Neuropathy

American College of Emergency Physicians 2012 Clinical Policy: Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department

American Pain Society 2014 Methadone Safety: A Clinical Practice Guideline

American Society of Anesthesiologists 2012 Practice Guidelines for Acute Pain Management in the Perioperative Setting

American Society of Clinical Oncology 2016 Management of Chronic Pain in Survivors of Adult Cancers

ASIPP 2006 American Society of Interventional Pain Physicians Guidelines for Responsible Opioid Prescribing in Chronic Non-Cancer Pain: Part 2 – Guidance

CDC 2016 CDC guideline for Prescribing Opioids for Chronic Pain – United States, 2016

Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131-7. Article

Colorado Division of Workers Compensation 2014 Low Back Pain Medical Treatment Guidelines

Colorado Division of Workers Compensation 2014 Cervical Spine Injury Medical Treatment Guidelines

Colorado Policy for Prescribing and Dispensing Opioids. 2014. Colorado Dental Board, Colorado Medical Board, State Board of Nursing, and State Board of Pharmacy.

Institute for Clinical Systems Improvement 2004 Diagnosis and Treatment of Chest Pain and Acute Coronary Syndrome

Kahan M, Wilson L, Mailis-Gagnon A, et al. Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 2: special populations. Can Fam Physician. 2011;57(11):1269-76, e419-28. Article

Manchikanti L, Abdi S, Atluri S, et al. American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non-cancer pain: Part 2 – guidance. Pain Physician. 2012;15(3 Suppl):S67-116. Article

National Guideline Alliance 2012 Opioids in Palliative Care: Safe and Effective Prescribing of Strong Opioids for Pain in Palliative Care of Adults

National Guideline Center 2016 Major Trauma: Assessment and Initial Management

National Guideline Center 2016 Spinal Injury: Assessment and Initial Management

National Guideline Center 2016 Fractures (Non-Complex): Assessment and Management

National Institute for Health and Clinical Excellence: Guidance 2016 Controlled Drugs: Safe Use and Management

National Institute for Health and Clinical Excellence: Guidance 2010 Pharmacological Management of Neuropathic Pain in Adults in Non-Specialist Settings

Ohio opioid prescribing guidelines. 2013

Scottish Intercollegiate Guidelines Network 2013 Management of Chronic Pain. A National Clinical Guideline

Society of Critical Care Medicine 1995 Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Trescot AM, Helm S, Hansen H, et al. Opioids in the management of chronic non-cancer pain. Pain Physician. 2008;11:S5-S62. Article

Trescot AM, Boswell MV, Atluri SL, et al. Opioid guidelines in the management of chronic non-cancer pain. Pain Physician. 2006;9:1-40. Article

Washington State Department of Labor and Industries 2013 Guideline for Prescribing Opioids to Treat Pain in Injured Workers

World Health Organization 2014 Community Management of Opioid Overdose

15.2 Animal Studies

Knabl J, Zeilhofer UB, Crestani F, et al. Genuine antihyperalgesia by systemic diazepam revealed by experiments in GABAA receptor point-mutated mice. Pain. 2009;141(3):233-8. Abstract

Munro G, Erichsen HK, Rae MG, Mirza NR. A question of balance – positive versus negative allosteric modulation of GABA(A) receptor subtypes as a driver of analgesic efficacy in rat models of inflammatory and neuropathic pain. Neuropharmacology. 2011;61(1-2):121-32. Abstract

Zeilhofer HU, Möhler H, Di Lio A. GABAergic analgesia: new insights from mutant mice and subtype-selective agonists. Trends Pharmacol Sci. 2009;30(8):397-402. Abstract

15.3 Epidemiology

King SA, Strain JJ. Benzodiazepine use by chronic pain patients. Clin J Pain. 1990;6(2):143-7. Abstract

Sun EC, Dixit A, Humphreys K, et al. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis. BMJ. 2017;356:j760. Article

15.4 Neuro Pharmacology

Brain Loci

Endogenous Substance Interaction

Receptor Effect

GABA Receptor

DeFeudis FV. Gamma-Aminobutyric acid-ergic analgesia: implications for gamma-aminobutyric acid-ergic therapy for drug addictions. Drug Alcohol Depend. 1984;14(2):101-11. Abstract

Enna SJ, McCarson KE. The role of GABA in the mediation and perception of pain. Adv Pharmacol. 2006;54:1-27. Abstract

Ignatov IuD, Andreev BV. Role of opioid and adrenergic mechanisms in the analgesic action of GABA-positive drugs. Biull Eksp Biol Med. 1988;105(5):556-8. Abstract

Knabl J, Witschi R, Hösl K, et al. Reversal of pathological pain through specific spinal GABAA receptor subtypes. Nature. 2008;451(7176):330-4. Abstract

Mirza NR, Munro G. The role of GABA(A) receptor subtypes as analgesic targets. Drug News Perspect. 2010;23(6):351-60. Abstract

Munro G, Hansen RR, Mirza NR. GABA(A) receptor modulation: potential to deliver novel pain medicines? Eur J Pharmacol. 2013;716(1-3):17-23. Abstract

Munro G, Ahring PK, Mirza NR. Developing analgesics by enhancing spinal inhibition after injury: GABAA receptor subtypes as novel targets. Trends Pharmacol Sci. 2009;30(9):453-9. Abstract

Sawynok J, GABAergic mechanisms of analgesia: an update. Pharmacol Biochem Behav. 1987;26(2):463-74. Abstract

Sivam SP, Ho IK. GABA in morphine analgesia and tolerance. Life Sci. 1985;37(3):199-208. Abstract

Tolerance

15.5 Pain Type Outcomes: Abdominal

15.6 Pain Type Outcomes: Acute

15.7 Pain Type Outcomes: Break Through

15.8 Pain Type Outcomes: Cancer

Greenberg DB. Strategic use of benzodiazepines in cancer patients. Oncology (Williston Park). 1991;5(4):83-8; discussion 88, 90, 95. Abstract

Triozzi PL, Goldstein D, Laszlo J. Contributions of benzodiazepines to cancer therapy. Cancer Invest. 1988;6(1):103-11. Abstract

15.9 Pain Type Outcomes: Centralized

Central Pain

Post-Stroke Pain

Complex Regional Pain Syndrome

Rowbotham MC. Pharmacologic management of complex regional pain syndrome. Clin J Pain. 2006;22(5):425-9. Abstract

Dystonia

Snaith A, Wade D. Dystonia. BMJ Clin Evid. 2008;2008. pii: 1211. Abstract

Fibromyalgia

Bennett RM, Jones J, Turk DC, et al. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8:27. Article

Corrigan R, Derry S, Wiffen PJ, Moore RA. Clonazepam for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2012;(5):CD009486. Abstract

Head: Chronic Daily Headache

D’Amico D, Grazzi L, Leone M, et al. A review of the treatment of primary headaches. Part II: Tension-type headache. Ital J Neurol Sci. 1998;19(1):2-9. Abstract

Hyperalgesia

Zeilhofer HU, Witschi R, Hösl K. Subtype-selective GABAA receptor mimetics–novel antihyperalgesic agents? J Mol Med (Berl). 2009;87(5):465-9. Abstract

IBS

Salari P, Abdollahi M. Systematic review of modulators of benzodiazepine receptors in irritable bowel syndrome: is there hope? World J Gastroenterol. 2011;17(38):4251-7. Article

Multiple Sclerosis

Myofascial Pain

Neuropathic Pain

Covington EC. Anticonvulsants for neuropathic pain and detoxification. Cleve Clin J Med. 1998;65 Suppl 1:SI21-9; discussion SI45-7. Abstract

Corrigan R, Derry S, Wiffen PJ, Moore RA. Clonazepam for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2012;(5):CD009486. Abstract

DPN

HIV-related Neuropathy

PHN

Opioid-Induced Hyperalgesia

Pelvic: Interstitial Cystitis / Pelvic Floor Dysfunction

Pelvic: Vulvodynia

Phantom Limb Pain

TMD

Hersh EV, Balasubramaniam R, Pinto A. Pharmacologic management of temporomandibular disorders. Oral Maxillofac Surg Clin North Am. 2008;20(2):197-210, vi. Abstract

15.10 Pain Type Outcomes: Chronic

15.11 Pain Type Outcomes: End of Life

Pain Type Outcomes: Cardiac

Bhangoo P, Parfitt A, Wu T. Best evidence topic report. Cocaine induced myocardial ischemia: nitrates versus benzodiazepines. Emerg Med J. 2006;23(7):568-9. Article

Huffman JC, Stern TA. The use of benzodiazepines in the treatment of chest pain: a review of the literature. J Emerg Med. 2003;25(4):427-37. Abstract

Pain Type Outcomes: Musculoskeletal

Manfredini D, Landi N, Tognini F, et al. Muscle relaxants in the treatment of myofascial face pain. A literature review. Minerva Stomatol. 2004;53(6):305-13. Abstract

15.12 Pain Type Outcomes: Musculoskeletal – Joint

Osteoarthritis

Rheumatoid Arthritis

Richards BL, Whittle SL, van der Heijde DM, Buchbinder R. The efficacy and safety of muscle relaxants in inflammatory arthritis: a Cochrane systematic review. J Rheumatol Suppl. 2012;90:34-9. Abstract

15.13 Pain Type Outcomes: Musculoskeletal – Spine

Brötz D, Maschke E, Burkard S, et al. Is there a role for benzodiazepines in the management of lumbar disc prolapse with acute sciatica? Pain. 2010;149(3):470-5. Abstract

Brown BR, Womble J. Cyclobenzaprine in intractable pain syndromes with muscle spasm. JAMA. 1978;240(11):1151-2. Abstract

Chou R. Pharmacological management of low back pain. Drugs. 2010;70(4):387-402. Abstract

Chou R, Huffman LH. Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147(7):505-14. Abstract

Hall H, McIntosh G. Low back pain (acute). BMJ Clin Evid. 2008;1102. Article

McCarberg BH. Acute back pain: benefits and risks of current treatments. Curr Med Res Opin. 2010;26(1):179-90. Abstract

Strumpf M, Linstedt U, Wiebalck A, Zenz M. Treatment of low back pain–significance, principles and danger. Schmerz. 2001;15(6):453-60. Abstract

C-spine

T-spine

LS-spine

Brötz D, Maschke E, Burkard S, et al. Is there a role for benzodiazepines in the management of lumbar disc prolapse with acute sciatica? Pain. 2010;149(3):470-5. Abstract

van Tulder MW, Touray T, Furlan AD, et al. Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the cochrane collaboration. Spine (Phila Pa 1976). 2003;28(17):1978-92. Abstract

Sacroiliac

15.14 Pain Type Outcomes: Pelvic

15.15 Pain Type Outcomes: Perioperative

Devabhakthuni S, Armahizer MJ, Dasta JF, Kane-Gill SL. Analgosedation: a paradigm shift in intensive care unit sedation practice. Ann Pharmacother. 2012;46(4):530-40. Abstract

Ho KM, Ismail H. Use of intrathecal midazolam to improve perioperative analgesia: a meta-analysis. Anaesth Intensive Care. 2008;36(3):365-73. Abstract

Sztark F, Lagneau F. Agents for sedation and analgesia in the intensive care unit. Ann Fr Anesth Reanim. 2008;27(7-8):560-6. Abstract

Comparative Outcomes to Other Medications

Acetaminophen

Alpha2 Antagonists

Calcium Channel Agents

Cannabinoids

Hormones

Medical Foods

Mono Amine Reuptake Inhibitors

Muscle Relaxants

Tizanidine

Groves L, Shellenberger MK, Davis CS. Tizanidine treatment of spasticity: a meta-analysis of controlled, double-blind, comparative studies with baclofen and diazepam. Adv Ther. 1998;15(4):241-51. Abstract

NMDA Receptor Antagonists

NSAIDs

Opioids

Sodium Channel Agents

Steroids

Stimulants

Topical Combinations

Triptans

TRPV₁ Agents

Combination Outcomes with Other Medications

Acetaminophen

Alpha2 Antagonists

Calcium Channel Agents

Cannabinoids

Hormones

Medical Foods

Mono Amine Reuptake Inhibitors

Muscle Relaxants

NMDA Receptor Antagonists

NSAIDs

Opioids

Sodium Channel Agents

Steroids

Stimulants

Topical Combinations

Triptans

TRPV₁ Agents

15.16 Combination Outcomes with Non-Pharmacologic Approaches

15.17 Benzodiazepines for Pain by Subpopulation

Addiction

Armed Services / Veterans

Cancer

Cardiovascular Disease

Care Facilities

Cognitive Dysfunction

Criminal Justice

Elderly

End of Life

Ethnicity

African-American

Asian

Caucasian

Hispanic

Native American

Pacific Island

Health Care Providers

Hepatic Disease

HIV / AIDS

LGBT

Men

Neurologic Disease

Multiple Sclerosis

Solaro C, Messmer Uccelli M. Pharmacological management of pain in patients with multiple sclerosis. Drugs. 2010;70(10):1245-54. Abstract

Pediatric

Nelson MA, Bradshaw WT. Use of benzodiazepines as anxiolytics in neonates: are we there yet? Adv Neonatal Care. 2014;14(2):78-85; quiz 86-7. Abstract

Psychiatric Disease

Renal Disease

Sleep Disorders

Insomnia

Sleep Apnea

Surgery

Bergendahl H, Lönnqvist PA, Eksborg S. Clonidine in pediatric anaesthesia: review of the literature and comparison with benzodiazepines for premedication. Acta Anaesthesiol Scand. 2006;50(2):135-43. Abstract

Dahmani S, Brasher C, Stany I, et al. Premedication with clonidine is superior to benzodiazepines. A meta analysis of published studies. Acta Anaesthesiol Scand. 2010;54(4):397-402. Abstract

Swallowing Disorders

Women

Perinatal

Nursing

Library 15 Benzodiazepines for Pain

15 Benzodiazepines for Pain

15.1 Reviews