Guidelines for prescribing opioids for chronic non-cancer pain in Korea

Abstract

As the treatment of chronic non-cancer pain gradually increases, clinicians have more opportunities to encounter opioid prescription. However, guidelines for prescribing opioids for chronic non-cancer pain have never been published in Korea. The present guidelines were prepared by reviewing various research data. In cases in which the data were insufficient, recommendations were presented following discussion among experts affiliated with the Opioids Research Group in the Korean Pain Society. The present guidelines may need to be continuously revised and amended as more clinical evidence is acquired.

Tratamiento con opiodes en dolor crónico no oncológico: Recomendaciones para una prescripción segura

“…Esta situación ha hecho que múltiples sociedades científicas elaboren guías sobre el uso racional de opioides (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Éstas establecen que los pacientes con factores de riesgo de adicción no necesariamente deben ser excluidos de la terapia con opioides si se ha determinado que precisan dicho tratamiento, sino que deben utilizarse después de establecer un plan terapéutico y de monitorización individualizada (15).…”

<p>Medicolegal Consideration to Prevent Medical Malpractice Regarding Opioid Administration: An Analysis of Judicial Opinion in South Korea</p>

“…17 However, the use of opioids in patients with chronic non-cancer pain has increased recently in Korea 5,7 and the guidelines for their use in these patients were recently published. 4 Therefore, in our study, most cases were associated with acute pain rather than chronic pain. In addition, few cases were associated with addiction and the most commonly used opioid in our study was pethidine, and it was mainly used for the treatment of acute pain.…”

“…22 It is recommended that in the outpatient setting, opioid administration should be started with the minimum dose and gradually increased as necessary. 4 In one of the cases not dismissed by the court, a transdermal fentanyl patch was prescribed to an opioid-naive patient with an initial dose of 50 mcg in an outpatient setting (case no. 18).…”

“…1,2 More recently, it has also played an important role in the management of chronic non-cancer pain. 3,4 Opioids have strong analgesic potency without a ceiling effect unlike other analgesics, and it can be administered through various routes such as transdermal, submucosal, intranasal, oral, neuraxial, or intravenous routes. 4 As a result, opioids are now being widely used for pain management, and their use has increased dramatically in South Korea.…”

“…3,4 Opioids have strong analgesic potency without a ceiling effect unlike other analgesics, and it can be administered through various routes such as transdermal, submucosal, intranasal, oral, neuraxial, or intravenous routes. 4 As a result, opioids are now being widely used for pain management, and their use has increased dramatically in South Korea. 5 According to the Adequacy of Consumption Measure (ACM) of opioids in 2010, opioid usage in South Korea has grown exponentially, with a 77-fold increase in ACM ratio between 2006 and 2010.…”