General considerations for the management of pain with any medication that contains an opioid mechanism of action

The following general aspects should be considered in the context of the product’s specific labelling:

Responsible Opioids Usage

​The following general aspects should be considered:

  • 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
  • In patients with acute pain e.g. post-surgery pain, the use of medication should be for the shortest necessary time.1
  • All patients should be carefully selected, abuse risk factors evaluated and regular monitoring and follow-up implemented to ensure that opioids are used appropriately3,4 and in alignment with treatment goals (pain intensity and functionality) as agreed with the patient.3,4
  • Patients should be made aware of the potential side effects of opioids and the potential of developing tolerance, dependence and addiction.3,4
  • It is important to optimally use multimodal, non-opioid approaches in acute and chronic pain before escalating to opioids or in conjunction with opioid therapy.1
  • Addiction is possible even when opioids are taken as directed. The exact prevalence of abuse in patients treated with opioids for chronic pain is difficult to determine.5
  •  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 treatment2
  • Any long term treatment with opioids should be monitored and re-evaluated regularly, including tapering down the dose or discontinuing treatment3,4
  • Signs of opioid use disorder should be monitored and addressed3,4
  • Patients and the general public can benefit from clear educational materials and awareness interventions to support the responsible use of opioids.6



1.DHHS Pain Management Best Practices Inter-Agency Taskforce Report May 2019.
2.O’Brien T et al. Eur J Pain 2017;21:3-192.
3.Faculty of Pain Medicine, Opioids Aware. Available at: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-aware (accessed September 2019).
4.Kosten TR et al, Scie Pract. Perspect 2002;1:13-20.
5.Rosenblum A et al Exp. Clin. Psychopharmacol. 2008;16(5):405-416.
6.OECD Health Policy. Addressing Problematic opioid use in OECD Countries May 2019. Available at: http://www.oecd.org/health/addressing-problematic-opioid-use-in-oecd-countries-a18286f0-en.htm (accessed January 2020).


M-N/A-UK-04-20-0010 April 2020



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