Chronic opioid therapy for nonmalignant pain: the patient's perspective. Part II--Barriers to chronic opioid therapy.

Opioid therapy has been shown to decrease pain intensity, restore levels of function, and improve quality of life for adults with chronic pain. Even so, opioids are rarely used as a long-term treatment option, and the prescription of opioid analgesics for managing chronic nonmalignant pain has remained a highly debated treatment modality. This ongoing debate has resulted in a stigma being associated with both the treatment modality and those individuals receiving it. As a result of these stigmas, a multitude of barriers have arisen for those individuals using opioids to control their chronic nonmalignant pain. Limited qualitative research exists that reflects patients' perspectives regarding the stigmatization and barriers that they encounter when using this treatment option. This paper reports part II of the results of a phenomenologic study that investigated the experience of 22 adults receiving opioid therapy for chronic nonmalignant pain, with a focus on associated stigmas and barriers to treatment. Overall, the data reflected that these individuals encounter much stigma surrounding their pain management regimen, and that the routine course of maintaining that regimen is fraught with barriers. These barriers arise from family, the health care system, and society at large. Awareness of the life-enhancing benefits of opioid therapy in adults with chronic nonmalignant pain, as well as the stigma and barriers that they encounter, will enable clinicians to intervene appropriately and to act as advocates on behalf of adults using chronic opioid therapy. (c) 2010 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.