Optimizing Opioid Use in Pain Management: A Comprehensive Review of Clinical Benefits, Risks, and Dependence - PubMed
5 hours ago
- #opioids
- #multimodal-therapy
- #pain-management
- Opioids are essential for managing moderate-to-severe pain in anesthesia, critical care, and perioperative medicine.
- Opioids work through μ-, δ-, and κ-opioid receptors, affecting central and peripheral pain pathways.
- They are well-established for acute postoperative and cancer-related pain but controversial for chronic non-cancer pain.
- Risks of dependence and addiction are lower in monitored patients but increase with psychological comorbidities or prior substance use.
- Global opioid management is complicated by unequal access, prescribing variability, and disparities.
- New strategies include partial agonists like buprenorphine, dual-mechanism agents like tapentadol, and multimodal analgesia.
- Non-pharmacological interventions (behavioral and physical therapies) complement opioids to reduce exposure and improve outcomes.
- Adverse effects like tolerance, hyperalgesia, sedation, and respiratory depression must be balanced with efficacy.
- Opioids should be part of a patient-centered, multimodal approach prioritizing safety and individualized risk mitigation.