BACKGROUND AND OBJECTIVES: Prolonged use of opioids is a possibility for chronic pain treatment. Opioids are effective for virtually all chronic noncancer pain syndromes, but may cause dependence. The aim of this paper is to review the use and rotation of opioids in chronic non-oncologic pain. CONTENT: The use of potent opioids is controversial and not recommended as first-line drugs due to the possibility of dependence. The following topics are described: tolerance, addiction, risk factors for addiction, rotation or replacement, general administration rules, conversion tables, and tips for prescribing opioids. CONCLUSIONS: Opioids are drugs with proven efficacy for chronic non-oncologic pain, but its prescription should meet certain criteria in order to reduce the incidence of adverse effects and addiction.
BACKGROUND AND OBJECTIVES: Prolonged use of opioids is a possibility for chronic pain treatment. Opioids are effective for virtually all chronic noncancer pain syndromes, but may cause dependence. The aim of this paper is to review the use and rotation of opioids in chronic non-oncologic pain. CONTENT: The use of potent opioids is controversial and not recommended as first-line drugs due to the possibility of dependence. The following topics are described: tolerance, addiction, risk factors for addiction, rotation or replacement, general administration rules, conversion tables, and tips for prescribing opioids. CONCLUSIONS: Opioids are drugs with proven efficacy for chronic non-oncologic pain, but its prescription should meet certain criteria in order to reduce the incidence of adverse effects and addiction.