Long-term use of narcotic analgesics in chronic pain

The use of narcotic analgesics have been avoided by clinicians in patients with chronic pain syndromes. Uncertainty as to the etiological cause of chronic pain, development of addiction and habituation and associated psychological and behavioral symptoms found in chronic pain states which are not amenable to narcotic medications are the major reasons narcotics are not prescribed. This communication describes the long-term use of low dose narcotic analgesics as a treatment component of a comprehensive pain management program and addresses the questions of whether or not narcotic efficacy is maintained in long-term use, improvement of patients' function is continued and side effects develop as a result of this treatment.