Pain Core Curriculum Module 3: Evidence for and Management of Opioids for Chronic Pain-Presentation

Video Transcription

Video Summary

Roger Chow from Oregon Health and Science University discusses evidence-based management of opioids for chronic pain with the aim of increasing healthcare professionals' competence in handling opioid use disorder. Highlighting the widespread prescription of opioids for chronic non-cancer pain in the U.S., the presentation covers opioid pharmacology, the risks and benefits of long-term opioid therapy, and approaches to starting, continuing, modifying, and tapering such treatments. Chow explains opioid classifications, potential for side effects, overdose risks tied to higher dosages, and the historical rise in opioid prescriptions, emphasizing the U.S.'s outsized share of opioid consumption globally.<br /><br />Chow outlines the minor benefits of opioids over placebos for pain intensity and functionality, while also pointing out high misuse rates and the non-superiority of opioids over non-opioid therapies. Strategies to mitigate risks include careful patient selection, starting with low doses, conducting urine tests, and avoiding high-risk drugs co-administration. He presents a case study of a slow tapering process that moved a patient from high to lower opioid doses without worsening pain, using additional non-opioid medications. Overall, it underscores cautious opioid use, with prioritization of non-opioid therapies and patient-centric monitoring and adjustment strategies.

Keywords

opioid management

chronic pain

opioid use disorder

opioid pharmacology

opioid therapy risks

non-opioid therapies

patient monitoring

opioid tapering