Recomendaciones de práctica clínica de la Sociedad Española Multidisciplinar de Dolor (SEMDOR) para el buen uso médico de los opioides de prescripción en el tratamiento del dolor crónico no oncológico

Opioid analgesics are essential and irreplaceable drugs in the treatment and control of pain. On the other hand, we must not forget that pain control is also an internationally recognized human right. However, the fear and rejection of the use of opioids as a result of the epidemic situation experienced in the United States has led to an undertreatment of patients, as Meyers and Quenzer state in their book on psychopharmacology, where they talk about how an unfounded fear of addiction has deprived many patients of receiving adequate pain relief. The treatment of pain is the responsibility of several health professionals, with Primary Care doctors prescribing these drugs the most, either by their own decision or by continuation of a prescription from the specialist. On the other hand, the incidence and prevalence of pain is expected to continue growing in the coming years mainly due to the greater survival of patients suffering from oncological and non-oncological pathologies. In this environment, it is essential to provide guidelines for the correct use of opioid drugs by prescribers and dispensers. To this end, SEMDOR present these recommendations on how to make good medical use of opioid drugs to treat chronic non-oncological pain (persistent or recurrent) lasting more than 3 months. These recommendations provide specific guide for addressing the selection of patients eligible for opioid treatment, as well as for initiation, follow-up, monitoring, or discontinuation of treatment. Additionally, recommendations are established on the responsibilities and resources that affect doctors, pharmacists and patients. Finally, we provide some points of improvement that should be implemented in relation to the management of opioid drugs at the level of health systems to enhance the systems for measuring prescriptions and adverse events, optimize dispensing with the use of new technologies, advance in multidisciplinary coordination and establish quick and simple means to communicate clinical recommendations such as the one presented here to all stakeholders. As a special warning, it should be noted that the intention of these document is not to contradict any other guide or protocol established at the level of scientific societies or institutions, but to serve as a guide and help in the day to day of clinical practice, incorporating the recommendations that we consider most appropriate to the clinical reality with the aim of guiding prescribing doctors and pharmacists towards the good medical use of opioid drugs.