Grünenthal’s charter on the responsible medical use of opioids and overview of medication that contains an opioid mechanism of action

*General considerations for the management of pain with any medication that contains an opioid mechanism of action

The following general aspects should be considered

• An individualized, patient-centered approach for the diagnosis and treatment of pain is essential to establish a therapeutic alliance between patient and clinician.
• Consider patient variables that may affect opioid dose for each patient prior to opioid use ⁽¹⁾
• In patients with acute pain e.g. post-surgery pain, the use of medication should be for the shortest necessary time ⁽¹⁾
  All patients should be carefully selected, abuse risk factors evaluated and regular monitoring and follow-up implemented to ensure that opioids are used appropriately ^(3-4) and in alignment with treatment goals (pain intensity and functionality) as agreed with the patient ^(3-4)
• Patients should be made aware of the potential side effects of opioids and the potential for developing tolerance, dependence and addiction ^(3-4).
• It is important to optimally use multimodal, non-opioid approaches in acute and chronic pain before escalating to opioids or in conjunction with opioid therapy ⁽¹⁾
• Addiction is possible even when opioids are taken as directed. The exact prevalence of abuse in patients treated with opioids for chronic pain is difficult to determine ⁽⁵⁾
• Regular clinical reviews are required for long-term opioid treatment to assess pain control, impact on lifestyle, physical and psychological well-being, side effects and continued need for treatment ⁽²⁾
• Any long term treatment with opioids should be monitored and re-evaluated regular incl. tapering down the dose or discontinuing treatment ^(3-4)
• Signs of opioid use disorder should be monitored and addressed (3-4)
• Patients and the general public can benefit from clear educational materials and awareness interventions to support the responsible use of opioids ⁽⁶⁾
  
  

M-N/A-HQ-02-20-0012

1. DHHS Pain Management Best Practices Inter-Agency Taskforce Report May 2019
2. O’Brien T et al. Eur J Pain 2017;21:3-192
3. Faculty of Pain Medicine, Opioids Aware https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-aware Accessed September 2019
4. Kosten TR et al, Scie Pract. Perspect 2002;1:13-20
5. Rosenblum A et al Exp. Clin. Psychopharmacol. 2008;16(5):405-416
6. OECD Health Policy. Addressing Problematic opioid use in OECD Countries May 2019 http://www.oecd.org/health/addressing-problematic-opioid-use-in-oecd-countries-a18286f0-en.htm

For Grünenthal’s charter on the responsible medical use of opioids, please open the following document.

Overview of medication that contains an opioid mechanism of action