Non-cancer chronic pain and the opioid crisis: narrative review

Abstract

This narrative review presents a series of aspects related to the expansion of the use of opioid drugs for the treatment of chronic non-cancer pain. The main objective was to analyze current knowledge about the potential risks of prolonged use of opioid medications with an emphasis on the development of tolerance, poisoning, and fatal overdoses. The review was built through the integration of population research results published on the subject, clinical protocols for the management of chronic pain and the report of the Stanford-Lancet commission on the opioid crisis in North America. Some aspects related to chronic non- cancer pain were discussed as to the characteristics of natural, semi-synthetic, and synthetic opioids; their prescription; the crisis observed in the United States and Canada in the last 25 years, and the risk of occurrence in other countries, as well as some proposals to face this problem. It is relevant to the complexity of the problem the different interactions between the clinical use and the recreational one of these narcotics, and the lack of solid scientific evidence on the effectiveness of the treatment for chronic pain, it is concluded that there is a need for greater technical and scientific development aimed at meeting health needs and reducing associated risks.