Peer Reviewed
Perspectives

Use of opioids in chronic noncancer pain

Stephan A Schug, Mir Wais Sekandarzad
Abstract

Opioids play a much smaller role in the management of chronic noncancer pain than they do in that of severe acute pain and cancer pain. They are beneficial in a small subset of patients with chronic noncancer pain but there are pharmacological, psychological and societal concerns about their current widespread use for this indication.

Key Points
    • There are pharmacological, psychological and societal concerns about the current widespread use of opioids for chronic noncancer pain.
    • Opioids should not be regarded as the sole approach to managing chronic noncancer pain but as one component of a multidisciplinary management plan.
    • They should only be used for this type of pain after an initial trial with defined positive outcomes, in particular improvement of function.
    • They are not intended as life-long treatment and should be discontinued by tapering the dose when treatment goals are reached (or aberrant drug-taking behaviour becomes obvious).
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