Opioids should not be considered as the first choice for patients with non-malignant chronic pain. The evidence is rather scarce and they should only be prescribed when pain is severe and continuous, and does not respond to other therapies. Management should be approached on an individual basis according to the patient’s health status, age, previous response to opioids and the risk of dependence. Treatment with an opioid should be started at the lowest dose (10mg oral morphine or equivalent), re-evaluated after 72 hours and continuously monitored. Opioids should be tapered off in case of lack of efficacy or severe side effects.

Authors:

• Mª Concepción Celaya. Drug Prescribing Service. Navarre Health Service, Spain
• Mª Mar Malón. Planning and Clinical Management Service. Navarre Health Service, Spain