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Opioids in chronic pain Opioids in chronic pain
Browse our health professional information, resources and educational activities on pain management and opioids.
Key messages
- Perform a thorough history and physical examination to determine if investigations are necessary
- Prescribe an opioid only as part of an agreed pain management plan
- Initiate an opioid as a short term therapeutic trial
- Continue an opioid only in those who demonstrate benefit from a trial and reassess regularly the need for ongoing therapy
- Discuss options for managing breakthrough pain
Important links
- Brief Pain Inventory (external link)
- Abbey Pain Scale (external link; for patients with cognitive impairment)
- Download or order your copy of the NPS Medicines list
QUM rationale
Chronic (persistent) non-cancer pain is a common condition that affects 1 in 5 Australians. Managing a person with chronic pain involves a combination of non-pharmacological and pharmacological approaches. Opioids are increasingly used to treat chronic pain; however there is a lack of evidence about their long-term safety and efficacy.
The goals of opioid therapy in chronic pain are to reduce pain and improve function and overall quality of life. Opioids should be reserved for patients whom other analgesics (including an adequate trial of paracetamol ) are unsuitable or provide inadequate pain relief.
This program focuses on the use of opioid therapy as part of a broader approach to manage chronic pain and how to reassess the appropriateness of on-going prescribing.
| Title | Description | Content type | Date* |
|---|---|---|---|
| Using opioid medicines for your chronic pain | A patient information leaflet that can be used by doctors or pharmacists to explain the role of opioid medicines in chronic pain management | Patient Leaflet | 2010-06-01 00:00:00 |
| NPS News 69: A planned approach to prescribing opioids | Opioids (opiates) have a role as analgesics for chronic pain; however their long-term benefits and harms in this context are not well understood. | NPS News - Health Professional Publication | 2010-06-01 00:00:00 |
| Nurse Update July 2010 | Inform subscribing nurses about new issues of various NPS publications and allow them to click through to any articles of interest. | Nurses Update - Health Professional Publication | 2010-07-02 00:00:00 |
| Opioid-containing analgesics in chronic pain - pharmacy practice review sample pack | This Pharmacy Practice Review provides pharmacists with the opportunity to review their episode of care with patients who are regular users of opioid-containing analgesics for chronic pain, presenting with either a prescription or a request over the counter | Activity - Pharmacy Practice Audit | 2010-05-10 00:00:00 |
| Chronic pain — what can I do? | Chronic or persistent pain is when pain occurs most days of the week, for at least a three month period. About 1 in 5 Australians suffer from chronic pain and it most commonly occurs in older people. | Factsheet - Consumer | 2009-03-11 00:00:00 |
| NPS Prescribing Practice Review 51:Opioids in chronic non-cancer pain: use a planned approach | Information on using a planned approach when prescribing opioids for use in chronic non-cancer pain. | Prescribing Practice Review - Health Professional Publication | 2010-06-16 00:00:00 |
| Helping you manage pain | A booklet with information and a pain diary to manage your arthritis pain. | Tool - Consumer | 2009-11-25 00:00:00 |
| My pain management plan | Having structured plan can help chronic pain management | Patient Leaflet | 2010-06-01 00:00:00 |
| Clinical audit: Review of opioid prescribing in chronic pain | Clinical audit to assist GPs review their management of patients prescribed an opioid for chronic non-cancer pain (Sample pack) | Activity - Clinical Audit | 2010-06-30 00:00:00 |
| Case study 64:Opioid therapy in chronic pain | Winston is a 64-year-old artist who has come back to see you for worsening back pain. | Activity - Case Study | 2010-06-01 00:00:00 |
| My pain diary | Record changes in your chronic pain to help your pain management | Patient Leaflet | 2010-06-01 00:00:00 |
| Clinical audit: Review of opioid prescribing in chronic pain | Clinical audit to assist GPs review their management of patients prescribed an opioid for chronic non-cancer pain (Enrolment form) | Activity - Clinical Audit | 2010-06-30 00:00:00 |
Useful information from Australian Prescriber
| Content type | Date* | Title |
|---|---|---|
| Australian Prescriber - Article | 2006-06-01 00:00:00 | Drug treatment of neuropathic pain |
| Australian Prescriber - Article | 2004-04-01 00:00:00 | Does pethidine still have a place in the management of labour pain? |
| Australian Prescriber - Article | 2002-02-01 00:00:00 | Does pethidine still have a place in therapy? |
| Australian Prescriber - Article | 1999-10-01 00:00:00 | Non-organic pain in childhood |
| Australian Prescriber - Article | 1999-02-01 00:00:00 | Use of anticonvulsants for neuropathic pain |
| Australian Prescriber - Article | 1995-04-01 00:00:00 | Paracetamol: use in children |
| Australian Prescriber - Editorial | 2004-04-01 00:00:00 | Trouble with tramadol |
| Australian Prescriber - Experimental and clinical pharmacology | 1996-08-01 00:00:00 | Opioids: clinical applications in palliative care |
* Information current at date of publication.
