The treatment of chronic pain is a major worldwide public health issue. In 4 studies that used the International Association for the Study of Pain (IASP) definition for chronic pain, the prevalence of pain > 3 months duration ranged from 11.5% to 55.2%.
Although the benefits of many pain treatments have been demonstrated clinically, not all treatment aims have achieved their goals in practice owing to various factors including patient expectation and the complexity of treatment regimens. It has been observed that “increasing the effectiveness of adherence interventions might have a far greater impact on the health of the population than any improvement in specific medical treatments”.
Effective pain management with opioids should be an achievable goal in many patients with pain. In this review we will describe the factors that interfere with the optimal use of strong opioids for chronic pain, and propose strategies to overcome them.
Although the benefits of many pain treatments have been demonstrated clinically, not all treatment aims have achieved their goals in practice owing to various factors including patient expectation and the complexity of treatment regimens. It has been observed that “increasing the effectiveness of adherence interventions might have a far greater impact on the health of the population than any improvement in specific medical treatments”.
Effective pain management with opioids should be an achievable goal in many patients with pain. In this review we will describe the factors that interfere with the optimal use of strong opioids for chronic pain, and propose strategies to overcome them.