Safe prescribing of opioids for persistent non-cancer pain

Abstract

A judicious approach in considering opioid therapy and choosing an appropriate opioid is needed. After an initial opioid trial, therapy should only be continued when there is reasonable evidence that it is effective and safe. The evidence for harm associated with long-term opioid prescribing is mounting while there is little evidence to support long-term efficacy. In many cases, reducing and eventually stopping opioid therapy may be the best course of action. Commitment by both the prescriber and the patient to a treatment plan which includes regular reviews is essential if opioid therapy is prolonged.