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The difficulties of chronic pain treatment with opioid and non-opioid analgesics

Publication at First Faculty of Medicine |
2020

Abstract

The article describes possbilities of the pharmacological treatment of chronic pain. In particular, treatment of pain with strong opioids is accompanied by a number of complications with insufficient management, with the possibility, an exceptional or even fatal outcome.

Without treatment with use of strong opioids, treatment of severe chronic pain cannot be possible, but it is necessary to keep a few simple recommendations to correctly indicate and monitor the entire course of the treatment. In recent years, a new concept of opioid classification based on their receptor mechanism of action has been promoted, and this concept may be a guide to more gentle treatment with strong opioids, especially in noncancer pain.

Treatment of chronic pain with nonopioid analgesics, in particular with the use of NSAIDs, is also risky in terms of side effects and therapeutic interactions in improper management. Recommendations for the safe use of NSAIDs have been issued and should be followed.

Complementary pharmacotherapy for pain is topical treatment, which is accompanied by a minimum of side effects, but is only applicable to some types of neuropathic pain.