7. Conclusions
It is essential that all clinicians who treat patients
with chronic pain recognise that it is their
responsibility to provide effective pain management.
In order to do so, physicians must be knowledgeable
in general principles of pain management,
analgesic pharmacology, special issues
related to opioid therapy and the use of commonly
available agents. Opioid analgesics are the standard
of care for patients with moderate-to-severe
chronic cancer pain. How opioids should be used in patients with chronic non-cancer pain is still a
matter of debate. Further controlled clinical trials
are needed to better define the role of long-term
opioid therapy in patients with chronic non-cancer
pain, and to establish criteria for patient selection
and specific treatment algorithms. Given the large
personal and socioeconomic burdens of chronic
non-cancer pain, there is an increasing consensus
of opinion that opioid treatment should be considered
in selected patients after reasonable trials of
other agents have failed. In addition, it is recognised
that careful attention must be paid to treating
the whole patient and not just the pain. A balanced,
multidisciplinary approach that takes into account
the individual needs of each patient is advocated.
The ultimate imperative for all clinicians is to relieve
unnecessary pain.