• D T Cowan, L G Allan, S E Libretto, and P Griffiths.
• Academic Department of Anaesthesia, Northwick Park Hospital, Harrow, Middlesex, UK.
• Pain Med. 2001 Sep 1; 2 (3): 193-203.

ObjectivesThe prescription of strong opioid analgesics for chronic non-cancer pain (CNCP) is described as controversial and can result in misidentification of patients as drug abusers or individuals with an addiction. This study compared the effects of opioid drugs on CNCP patients and "street" users.Subjects/SettingThe groups comprised 36 CNCP patients attending a pain clinic and 39 street users, recruited on London streets.DesignCNCP patients were interviewed in a pain clinic and street users in a street setting. A questionnaire was used to assess drug craving, dose escalation, cessation of use, compulsion to use, effects on career, relationships and activities, experience of "highs," and problems due to intoxication. To assess physiological dependence, subjects answered questions on specific effects e.g. stomach pains, nausea/vomiting, cramps/aches, etc.). Efficacy was assessed in CNCP patients by determining analgesia and physical function.ResultsCNCP patients started therapy in the low dose range for oral morphine (ConclusionFindings suggest that CNCP patients prescribed strong opioid analgesics derive more benefit than harm.

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