Abstract
Chronic pain not associated with malignancy is experienced by a significant proportion of the Canadian population. As the quality of life and physical functioning are markedly impaired in patients with chronic non-cancer pain, clinicians have commonly turned to opioid therapy for pain management. Since the 1990s, the steady increase in dispensing of prescription opioids has paralleled trends in opioid-related hospitalizations, overdoses, and fatalities. In fact, over-prescription and longterm opioid therapy are among the many root causes fueling Canada’s rise in opioid addiction and opioid-related deaths. Physicians and medical regulators have responded to this public health crisis by developing the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain. The new evidence-based guideline aims to encourage safe prescribing practices, reduce and eliminate the use of opioid analgesics and promote non-opioid pharmacotherapy. While clear clinical guidelines will optimize physician prescribing patterns, it is imperative to recognize the need for non-pharmacological modalities for pain management, treatment, and care to holistically address the complex roots of opioid abuse.
Highlights
Chronic pain not associated with malignancy is experienced by a significant proportion of the Canadian population
The sharp increase in prescription opioid analgesic use since the 1990s can be partly explained by aggressive pharmaceutical marketing strategies that encouraged primary care physicians to identify and treat chronic pain with opioids, despite a lack of evidence for using opioids for this indication.[10]
In Vancouver, BC, a growing trend in the availability of prescription opioids in people who inject drugs is evident between 2010 and 2014.12 Nonmedical prescription opioid use (NMPOU) was significant among street youth and adults, and more than one-third of these individuals engaging in NMPOU had initiated the use of prescription opioids prior to illegal drug use.[13]
Summary
Chronic pain not associated with malignancy is experienced by a significant proportion of the Canadian population.
Published Version (Free)
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