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pISSN 2005-9159
eISSN 2093-0569

Review Article

Korean J Pain 2024; 37(2): 119-131

Published online April 1, 2024 https://doi.org/10.3344/kjp.24022

Copyright © The Korean Pain Society.

Updated guidelines for prescribing opioids to treat patients with chronic non-cancer pain in Korea: developed by committee on hospice and palliative care of the Korean Pain Society

Minsoo Kim1 , Sun Kyung Park2 , Woong Mo Kim3 , Eunsoo Kim4 , Hyuckgoo Kim5 , Jun-Mo Park6 , Seong-Soo Choi7 , Eun Joo Choi8

1Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea, 2Department of Anesthesiology and Pain Medicine, Jeju National University College of Medicine, Jeju, Korea, 3Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea, 4Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea, 5Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea, 6Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea, 7Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, 8Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Correspondence to:Woong Mo Kim
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea
Tel: +82-62-220-6895, Fax: +82-62-232-6294, E-mail: kimwm@jnu.ac.kr

*These authors contributed equally to this work.

Handling Editor: Francis S. Nahm

Received: January 18, 2024; Revised: February 24, 2024; Accepted: March 4, 2024

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.

Keywords: Adult, Analgesics, Chronic Pain, Drug Monitoring, Drug Prescriptions, Opioid-Related Disorders, Prescription Drug Misuse, Treatment Outcome