Despite a dramatic increase in opioid prescriptions in the past two decades, a new federal study says there is no good research to guide doctors on the risks or effectiveness of their long-term use for ailments such as back pain and osteoarthritis.

In recent years, the widespread use of prescription opioids has sparked alarm: Their use was declared an epidemic in 2007 by the U.S. Centers for Disease Control and Prevention, and the government reported in 2011 that more than half of the nation’s 41,340 drug overdose deaths were related to pharmaceuticals. 

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