An individualised, patient-centred approach for diagnosis and treatment of pain is essential to establish a therapeutic alliance between patient and clinician. Consider patient variables that may affect opioid dose in patients prior to opioid use.1
Patients should be carefully selected and regularly monitored to ensure that opioids are prescribed appropriately.2, 3
Clear treatment goals related to pain and function should be agreed with the patient.2, 3
Patients should be made aware of the potential side effects of opioids and the potential of developing tolerance, dependence and addiction.2, 3
Addiction is possible even when opioids are taken as directed. The exact prevalence of addiction in patients treated with opioids for chronic pain is difficult to determine.4
Regular clinical reviews are required for long-term opioid treatment to assess pain control, impact on lifestyle, physical and psychological wellbeing, side effects and continued need for treatment e.g.5
- The treatment should be reconsidered incl. tapering down the dose or discontinuing treatment with opioids2, 3
- When opioids are used long-term, patients should be kept under close surveillance5
- Signs of addictive behaviour should be monitored and addressed2, 3
- Risk factors for opioid use disorder should be assessed before opioid prescription2
Patients and the general public can benefit from clear educational materials and awareness interventions to increase the rational use of opioids.6
1.Department of Health and Human Services. Pain management best practices inter-agency taskforce report. May 2019.
2. Faculty of Pain Medicine, Opioids Aware.
3.Kosten TR et al. Sci Pract Perspect 2002; 1(1):13–20.
4.Rosenblum A et al. Exp Clin Psychopharmacol. 2008; 16(5):405–416.
5.O’Brien T et al. Eur J Pain 2017; 21(1):3–19.
6. OECD Health Policy. Addressing Problematic opioid use in OECD Countries May 2019.
M--UK-01-20-0011 February 2020