Rethinking chronic pain treatment with opioids

Abstract

Opioid analgesics are defined as drugs that stimulate opioid receptors, primarily used in the treatment of moderate to severe pain. Since the discovery of opioids, they are considered as the most effective drugs for the pain relief. Even today, they are considered as the standard care in some of the countries for different pain conditions. Controversy remains for the treatment of long term pain in non-cancer and cancer patients. The main concerns with such treatment option are abuse liability, uncertainties in safety and effectiveness. Due to the abuse and dependence of opioids, regulatory restrictions were posed even though they have clinical use. Many legal regulatory authorities have provided guidelines for their use in the long term treatment. Even today, the great challenge exists with clinical community to deal with abuse and addiction of these opioid drugs, finally leading to limited usage of the opioids for treatment. This review focuses on the pain signalling and opioid pharmacology, opioid use in the chronic and cancer pain, different opioid drugs and their selection, drawbacks with these opioids drugs and strategies and approaches towards their effective use. If these opioidal drugs are prescribed with precautions under continuous observation and follow up for patients, definitely the central opioid analgesics would be best medication for chronic and cancer pains.