The use of opioid medications in patients with chronic non-malignant pain who have drug dependence.

The use of opioid medications in the management of painful medical conditions is currently being 'rediscovered'. However, although drug-dependent patients are likely to be over-represented in the chronic pain population and are also arguably less likely to respond to non-pharmacological interventions for chronic pain, opioid medications are considered to be relatively contraindicated for such a patient group. This paper explores, first, the background to this situation before proposing a set of interim guidelines for the use of opioid medications in the management of chronic pain in drug-dependent patients in order to protect access to this treatment strategy for this difficult patient group, while data from controlled studies are obtained for more definitive policy formation.

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