A partial review of the appropriate use of opioid analgesics in the treatment of chronic pain: Toward a model of good practice and rational pharmacotherapy

Chronic pain of noncancer origin affects upwards of 30% of the population of the United States. It is becoming increasingly clear that this common symptom is very difficult to treat. The complexities of the chronic pain patient contribute to the lack of efficacy in treatment, however some specific treatments are prob-lematic. One of these, the use of opioids for chronic pain of noncancer origin, is especially challenging. Opioids have been used for millennia and do provide relief in the appropriate patient. However, they carry with them side effects and significant psychosocial risks. Opioids should be used within the context of a model of good practice and rational pharmacotherapy. This article is a partial review of the appropriate use of opioids in the treatment of chronic pain of noncancer origin.