ABSTRACT
The use of narcotics in the management of chronic non-cancer pain (CNCP) is an important but extremely controversial subject. CNCP is a biological, psychological, and sociological phenomenon. All aspects of these problem areas must be appropriately diagnosed and treated. The most common forms of CNCP include: myofascial pain syndromes; fibromyalgia; neuropathic pain; radiculopathies; failed back syndromes; sympathetically maintained pain—secondary to autonomic nervous system dysfunction; arthritis; and chronic headache. The biological-psychological-sociological phenomenon that encompasses CNCP is most effectively treated, in terms of time, cost, and clinical considerations, within the framework of an interdisciplinary pain-management program. The treatment of the CNCP patient with only narcotics is problematic and most often leads to failure. Clinically, many patients with CNCP with a very poor quality of life can improve their function with the use of time release opioid pain medications. Opioid therapy can be enhanced via the use of adjunctive medications.
