Systematic review of chronic opioid use in non-cancer pain of adults

Purpose: The purpose of the systematic review is to identify patterns in the usage of opioids for chronic non-cancer pain and to assess the effectiveness of opioids in a chronic setting and the risk factors for their use. This assessment will allow us to target specific measures for at-risk populations and prevent opioid dependency and side effects.

Methods: This systematic review included a questionnaire of chronic non-cancer pain patients on codeine of 30mg/500mg to gain a personal perspective. The questionnaire findings were then used to create search criteria to identify ten papers. These criteria included specific inclusion and exclusion criteria, such as long-term observational studies, including patients with a history of anxiety and depression, and exclusion of cancer pain.

Results: The effectiveness of opioids in an acute setting has been proven, but the efficacy in the chronic setting is disputable. This "pain relief" may be due to opioid hyperalgesia and dependence. As a result, it suggests that opioid usage by adults with chronic non-cancer pain is due to addiction rather than the analgesic effect. Some of the significant risk factors for opioid use are increasing age, history of anxiety or depression, post-surgery opioid prescription and socioeconomic status.

Conclusion: The modifiable risk factors for opioid use include prescribers' and students' outlook on pain management, type of opioid and timing of opioid prescriptions. Therefore, this allows us to implement specific guidelines and changes to undergraduate teaching to prevent doctors' high prescribing behaviours and protect patients from opioid dependence and addiction.