Long-term strong opioid use in chronic noncancer pain patients in primary care settings

Noncancer chronic pain may affect up to 27% of adults in Poland. Chronic pain is a significant burden on health care system, but most of all it is significant source of unnecessary suffering for patients and their families. Chronic pain, regardless of origin, significantly worsens physical and psychological functioning of the patient, so the treatment goal is not only pain relief, but quality of life improvement as well.

According to the national and international experts’ recommendations chronic pain treatment, regardless of etiology, should be multidirectional, including pharmacotherapy, invasive methods, psychological procedures, rehabilitation and neuromodulation. Pharmacotherapy is still the most accessible and easy to use method, even by general practitioners.

Most concerns and controversy raises from the use of strong opioids in patients without cancer disease, but according to the recommendations these drugs should be used in pain of moderate to severe intensity, regardless of its etiology.

The article presents the basic principles and recommendations of the use of strong opioids in chronic pain patients of non-malignant origin, developed by experts of Polish Association for the Study of Pain, Polish Neurological Society and Polish Society of Family Medicine. These recommendations should be helpful in chronic pain treatment in both specialized and primary care.