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Difficult Decisions: Managing Chronic Neuropathic Pain With Opioids

England, John D. MD, FAAN; Franklin, Gary M. MD, MPH, FAAN

doi: 10.1212/01.CON.0000411547.51324.38
Practice Issues

The decision to use opioids to treat chronic neuropathic pain is complex and somewhat controversial. Although opioid therapy may be appropriate for some patients with chronic neuropathic pain, physicians must implement strategies to reduce opioid abuse, addiction, and diversion. The decision to use chronic opioids should be made proactively with institution of best practices to ensure safe and effective use. As with all aspects of chronic pain management, better education of both health care providers and patients is necessary. Fortunately, specific recommendations for the safe and effective use of opioids are now available in several recently published guidelines. The best practices embodied in these guidelines should be considered for widespread adoption by both individual providers and health care systems.

Address correspondence to Dr John England, LSUHSC School of Medicine, 1542 Tulane Avenue, Room 763, Department of Neurology, New Orleans, LA 70112,

Relationship Disclosure: Dr England serves as a member of the speakers’ bureau for Talecris Biotherapeutics and has served as an expert witness for a neurotoxicology litigation related to acrylamide/polyacrylamide. Dr Franklin has served as an expert witness in two legal cases regarding opioids.

Unlabeled Use of Products/Investigational Use Disclosure: Drs England and Franklin report no disclosures.

© 2012 American Academy of Neurology
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