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Opioid use in chronic pain

H J McQuay1

  • 1Pain Relief Unit, Churchill Oxford Radcliffe Hospital, UK.

Acta Anaesthesiologica Scandinavica
|January 1, 1997
PubMed
Summary

Evidence gaps persist for opioid use in chronic pain management, hindering optimal treatment. This review discusses opioid efficacy, adverse effects, and prescription challenges in non-cancer pain, highlighting the need for more randomized trials.

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Area of Science:

  • Pain Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Significant knowledge gaps exist regarding the optimal use of opioids for chronic pain management.
  • A lack of robust randomized controlled trials limits evidence-based prescribing and patient guidance.
  • Opioid therapy for chronic pain presents complex challenges for both prescribers and patients.

Purpose of the Study:

  • To review the current evidence on opioid efficacy in managing different types of chronic pain.
  • To discuss key reasons for the perceived failure of opioids in pain relief.
  • To address specific adverse effect concerns associated with opioid use and explore challenges in non-cancer pain prescription.

Main Methods:

  • Literature review and synthesis of existing research on opioid therapy for chronic pain.
  • Discussion of clinical scenarios and evidence limitations.
  • Analysis of adverse effects and prescription patterns in non-cancer pain populations.

Main Results:

  • Opioid effectiveness in relieving incident and neuropathic pain remains inadequately supported by evidence.
  • Specific adverse effects of opioid use require careful consideration in clinical practice.
  • The prescription of opioids for non-cancer chronic pain is a complex and debated issue.

Conclusions:

  • There is a critical need for more high-quality randomized trials to inform opioid prescribing in chronic pain.
  • Understanding the reasons for opioid treatment failure and managing adverse effects are crucial.
  • Evidence-based guidelines are needed to navigate the complexities of opioid use in non-cancer pain.

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