OPIOIDS FOR CHRONIC PAIN OF NONMALIGNANT ORIGIN - CARING OR CRIPPLING

Pain management has improved in the past few decades. Opioid analgesic s have become the mainstay in the treatment of cancer pain whilst inte r-disciplinary pain management programmes are the generally accepted a pproach to chronic pain of non-malignant origin. Recently some pain sp ecialists have advocated the use of opioids in the long-term managemen t of non-cancer pain. This has raised some fundamental questions about the purpose of pain management. Is it best to opt for maximum pain re lief and comfort, or should one emphasise function and activity as hig her priorities? Will the use of opioids create more autonomy for pain sufferers or will this add handicaps to lives which are already limite d? Until more clinical outcome data are available we advocate caution in the use of opioid analgesia. Such caution can, and does, raise ques tions about the rights of the patient and the rights of the prescriber in a context where the facts do not point to a clear course of action .