A balancing act is required when caring for a patient with chronic non-cancer pain.
On one side, you want to optimise the first-line therapies. These include non-pharmacological treatments such as patient education, gradually increasing physical activity and cognitive behavioural therapy (CBT). They may also include non-opioid medicines such as paracetamol and non-steroidal anti-inflammatories (NSAIDs).1,2
On the other side, you want to minimise therapies such as opioids that have a limited role.3,4
Opioids can be an effective component of the management of acute and cancer-related pain. However, evidence shows that for most patients with chronic non-cancer pain, opioids do not provide clinically important improvement in pain or function compared with placebo.3
In contrast, they carry significant risk of harm. Around 80% of people taking opioids for 3 months or more experience harms. These range from mild through to severe and fatal.5,6