Peer Reviewed
Feature Article Pain medicine
The judicious use of opioids in managing chronic noncancer pain
Abstract
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.
Key Points
- 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.
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