Extended-Release and Long-Acting Opioids for Chronic Pain Management

Paul A. Sloan, MD; Mellar P. Davis, MD, FCCP

doi:10.5055/jom.2014.0228

Authors

Paul A. Sloan, MD
Mellar P. Davis, MD, FCCP

DOI:

https://doi.org/10.5055/jom.2014.0228

Keywords:

opioids, REMS, extended-release opioids, long-acting opioids, chronic pain management, pain management

Abstract

Chronic pain from both cancer and noncancer sources affects approximately one quarter of the adult population in the United States. In addition to the considerable health burden, there is the burden of the patient suffering, loss of work productivity, and loss of social effectiveness for many patients. Untreated chronic pain has been documented to interfere with sleep patterns, increase anxiety and depression, decrease quality of life, and interfere with social relationships and the ability of a patient to cope with life. Long-term opioid therapy for the management of chronic-nonmalignant pain (CNMP) has been used with a subset of patients and found to be efficacious. Although the treatment of patients suffering from CNMP is viewed as humanitarian, their use has been complicated by side effects such as constipation, dose escalation, sedation, endocrine suppression, inadequate analgesic effect, prescription opioid diversion, and unwanted prescription-opioid- related death. Thus, a healthcare professional taking care of patients using long-term opioid therapy must be extremely well versed in the appropriate assessment, management, and specific pharmacology of opioid analgesic products.

Author Biographies

Paul A. Sloan, MD

Department of Anesthesiology, University of Kentucky Medical Center, Lexington, Kentucky

Mellar P. Davis, MD, FCCP

Department of Solid Tumor Oncology, Cleveland Clinic, Taussig Cancer Institute, Cleveland, Ohio

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