Chronic opioid therapy for nonmalignant pain: the patient's perspective. Part I--life before and after opioid therapy.

Prescription of opioid analgesics for managing chronic nonmalignant pain is a highly debated treatment modality. Although opioid therapy has been shown to decrease pain intensity, improve quality of life, and enhance functioning for adults with pain, opioids are rarely used as a long-term treatment option. Limited qualitative research exists that reflects patients' perspectives regarding life with chronic nonmalignant pain. This paper reports the results of a phenomenologic study that investigated the experience of 22 adults receiving opioid therapy for chronic nonmalignant pain. Themes that emerged regarding life before and after treatment with opioid therapy are discussed in part 1 of this two-part series. Life before treatment with opioids was characterized by desperation and inability to function. Life after treatment with opioids was characterized by balancing, living a secret life, fear of losing the pain management regimen, and thankfulness for a life regained. Overall, the data reflected the fact that these individuals trade the incapacitation of chronic pain for secrecy to regain their life and improve their functional capacity and ability to perform self-care. Awareness of the life-enhancing benefits of opioid therapy in adults with chronic nonmalignant pain will enable clinicians to intervene appropriately and to act as advocates on behalf of adults using chronic opioid therapy.