Strong opioids for osteoarthritis in primary care?

For some patients with osteoarthritis, commonly used drugs taken alone or in combination, offer insufficient pain relief, or are inappropriate. One issue this raises is whether strong opioids might then have a place in treatment. Some GPs may be reluctant to prescribe strong opioids for osteoarthritis. This may be due to concerns about addiction or long-term use of controlled drugs for non-cancer pain. Here we review the evidence on strong opioids as adjunctive treatment in osteoarthritis.