The aim of drug therapy in patients with chronic noncancer pain is mainly symptom control. Opioids have a place in the treatment of some patients as part of a biopsychosocial framework that does not rely on pharmacotherapy alone.
- Symptom control in the patient with chronic pain is an important aim of treatment, as part of a multimodal approach and as a passport to improved quality of life.
- Consider the use of opioids for managing chronic pain when non-opioid drugs have been found to be ineffective or not tolerated.
- Before prescribing opioids, assess psychological status, history of substance abuse and social context.
- Opioid treatment is an ongoing trial of therapy: response to opioids and problems with opioids are difficult to predict.
- Regularly assess the six As: analgesia, activity, adverse effects, affect, aberrant behaviours and accurate records.
- Seek advice if an apparent increase in opioid requirement is occurring.