Recommendations for using opioids in chronic non‐cancer pain

Abstract

1. The management of chronic pain should be directed by the underlying cause of the pain. Whatever the cause, the primary goal of patient care should be symptom control. 2. Opioid treatment should be considered for both continuous neuropathic and nociceptive pain if other reasonable therapies fail to provide adequate analgesia within a reasonable timeframe. 3. The aim of opioid treatment is to relieve pain and improve the patient's quality of life. Both of these should be assessed during a trial period. 4. The prescribing physician should be familiar with the patient's psychosocial status. 5. The use of sustained-release opioids administered at regular intervals is recommended. 6. Treatment should be monitored. 7. A contract setting out the patient's rights and responsibilities may help to emphasize the importance of patient involvement. 8. Opioid treatment should not be considered a lifelong treatment.

Prolonged‐release oxycodone/naloxone for chronic pain

“…Opioids may be useful for neuropathic and nociceptive pain if other strategies fail to provide adequate analgesia within a reasonable time. 4 Opioids are an important treatment option but they must be carefully prescribed and their use managed appropriately.…”

“…Opioids may be useful for neuropathic and nociceptive pain if other strategies fail to provide adequate analgesia within a reasonable time. 4 Opioids are an important treatment option but they must be carefully prescribed and their use managed appropriately.A large meta-analysis of 41 randomised trials involving 6019 patients with nociceptive pain (osteoarthritis, rheumatoid arthritis or back pain), neuropathic pain Prolonged-release oxycodone/ naloxone for chronic pain Naloxone binds selectively to intestinal opioid receptors, without blocking the analgesic effect of oxycodone. …”

Neuropathic pain—Current concepts

“…transdermal fentanyl, and sustained release oral morphine, should be used. 60,61 Short-acting and injectable opioids may predispose to tolerance and dependence. Effective pain relief should be accompanied by improved physical and psychosocial functioning.…”

Pain and its Management in Developing Countries

“…Improvements of this kind are possible if use is made of the guidelines published by the WHO, together with the International Narcotics Control Board on achieving balance in a national opioids control policy [103]. At the present time, the WHO is developing a program to assist countries in improving access to medications controlled under the drug conventions [6].…”