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.
- 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).