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Managing chronic nonmalignant pain: Overcoming obstacles to the use of opioids

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Abstract

Physicians involved in cancer pain management treat thousands of patients with opioids, whose effective analgesia improves overall functioning. Side effects generally are tolerable, and treatment can be maintained with stable doses for long periods. Problems with addiction are infrequent. Many physicians, however, assume that opioids should be used only for chronic malignant pain. Research and clinical experience have demonstrated that opioids can safely and effectively relieve most chronic moderate to severe nonmalignant pain. Fears of addiction, disciplinary action, and adverse effects result in ineffective pain management. With current information on the use of opioids in chronic nonmalignant pain, primary care physicians can overcome these obstacles. Guidelines must clearly define the role of the primary care physician in the proper management of pain and the integration of opioid therapy. Used appropriately, opioids may represent the only source of relief for many patients.

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Authors and Affiliations

  1. Oncology Symptom Control Research Community Cancer Care, Inc., Indiana University School of Medicine, Indianapolis, Indiana

    Steven D. Passik Ph.D. (Adjunct Clinical Professor of Psychology)

  2. Division of Neurosciences Hospital for Joint Diseases-Orthopaedic Institute, New York University Medical Center, New York, New York

    Herman J. Weinreb M.D. (Chief, Associate Professor of Clinical Neurology and Psychiatry)

Authors
  1. Steven D. Passik Ph.D.
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  2. Herman J. Weinreb M.D.
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Passik, S.D., Weinreb, H.J. Managing chronic nonmalignant pain: Overcoming obstacles to the use of opioids. Adv Therapy 17, 70–83 (2000). https://doi.org/10.1007/BF02854840

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