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Please use this identifier to cite or link to this item: http://hdl.handle.net/11055/815
Title: Opioid use in chronic non-cancer pain--part 1: known knowns and known unknowns.
Authors: Holliday S
Hayes C
Dunlop A
ANZCA/FPM Author: Hayes, C
Keywords: analgesics, opioid
pain management
opiate alkaloids
opioid-related disorders
drug overdose
chronic pain
Issue Date: Mar-2013
Citation: 42(3):98-102.
Abstract: BACKGROUND: Opioids have a critical, time-limited role in our management of acute and terminal pain and an open-ended role in our management of opioid dependency. They also have a use in the management of chronic non-cancer pain. OBJECTIVE: To provide an understanding of what is known, and what is not known, about the use of opioids in chronic non-cancer pain using an evidence-based approach. DISCUSSION: For chronic non-cancer pain, the evidence base for the long-term use of opiates is mediocre, with weak support for minimal improvements in pain measures and little or no evidence for functional restoration. Much research and professional education in this field has been underwritten by commercial interests. Escalating the prescribing of opioids has been repeatedly linked to a myriad of individual and public harms, including overdose deaths. Many patients on long-term opioids may never be able to taper off them, despite their associated toxicities and lack of efficacy. Prescribers need familiarity with good opioid care practices for evidence-based indications. Outside these areas, in chronic non-cancer pain, the general practitioner needs to use time and diligence to implement risk mitigation strategies. However, if a GP believes chronic non-cancer pain management requires opioids, prescribing must be both selective and cautious to allow patients to maintain, or regain, control of their pain management.
URI: http://hdl.handle.net/11055/815
Journal Title: Australian family physician
Type: Journal Article
Study/Trial: Editorial
Appears in Collections:Scholarly and Clinical

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