THE USE OF OPIOID MEDICATIONS IN PATIENTS WITH CHRONIC NONMALIGNANT PAIN WHO HAVE DRUG-DEPENDENCE

The use of opioid medications in the management of painful medical con ditions is currently being 'rediscovered'. However, although drug-depe ndent patients are Likely to be over-represented in the chronic pain p opulation and are also arguably less likely to respond to non-pharmaco logical interventions for chronic pain, opioid medications are conside red to be relatively contraindicated for such a patient group. This pa per explores, first, the background to this situation before proposing a set of interim guidelines for the use of opioid medications in the management of chronic pain in drug-dependent patients in order to prot ect access to this treatment strategy for this difficult patient group , while data from controlled studies are obtained for more definitive policy formation.