Canadian Guideline Offers Methods for Opioid Use in Chronic Non-Cancer Pain

Canadian Guideline Offers Methods for Opioid Use in Chronic Non-Cancer Pain

Opioid is critical for those needing chronic pain treatment. At the same time, this drug has been a part of countless instances of misuse, serious injuries and overdose deaths. In response to this growing problem, Canadian colleges of physicians and surgeons have created a new guideline for opioid use with chronic non-cancer pain.

In a recent Science Daily release, the opioid use problem in Canada was explored, including the significant 50 percent increase in recorded prescription-opioid consumption between 2000 and 2004. Today, Canada is the world’s third largest opioid consumer per capita.

The National Opioid Use Guideline Group (NOUGG) was created by Canadian medical regulators and was formed in November 2007. The NOUGG created the Canadian Guideline in an effort to help develop and implement a guidance for physicians with information to prescribe opioids safely and effectively to patients suffering from chronic non-cancer pain.

"The Canadian Guideline is intended to assist physicians with decisions to initiate appropriate trials of opioid therapy for patients with chronic non-cancer pain, to monitor long-term opioid therapy, and to detect and respond appropriately to situations of opioid misuse including addiction," wrote Clarence Weppler, Co-chair of the National Opioid Use Guideline Group and coauthors. "It was not designed to serve as a standard of care nor as a training manual."

The Canadian Guideline is designed for primary-care physicians and medical and surgical specialists who focus on managing patients with chronic non-cancer pain. The guide may also be useful for pharmacists, nurses and dentists, yet it does not discuss treatment of chronic pain with non-opioids.

Dr. Roger Chou noted that more studies of high-risk populations with long-term follow-up are necessary. A focus should also include optimal methods for risk stratification, patient selection, opioid initiation, dose titration, monitoring and discontinuation of therapy.

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