Clinicians' attitudes about prolonged use of opioids and the issue of patient heterogeneity.

Abstract

Despite advances in medical knowledge, sophisticated imaging procedures, and treatment approaches, a significant number of chronic pain patients continue to suffer from unremitting pain. Recently, it has been suggested that opioid analgesics should be used more extensively with this population. This suggestion has resulted in considerable controversy. The preliminary research upon which opioid use for chronic pain patients is based is reviewed and demonstrated to be equivocal. The results of two recent surveys that have addressed physicians' attitudes and prescribing practices for chronic pain patients are discussed. Proposed guidelines for prescribing opioids for chronic pain patients are examined.