Treat patients in pain carefully
“STARTING opioids is not a trivial decision, and opioids should not be commenced unless the doctor knows the patient and understands their psychosocial situation.”
This advice from Therapeutic Guidelines: Analgesic, about the treatment of chronic pain, is supported by the recently published results of a Canadian study. This study found that the GPs of patients who died from opioid-related causes were likely to be high prescribers of opioids. In the US, opioid-related deaths now exceed those from HIV.1
The rise in these deaths reflects the increasing use of opioids for chronic pain despite limited evidence for their long-term efficacy. Therapeutic Guidelines: Analgesic suggests that opioids should be considered if the patient has not benefited from other treatments.
The drugs should be only one part of a multidimensional management plan. The guidelines recommend that opioids be used initially for only a trial period.