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The Journal of the American Board of Family Medicine 19:165-177 (2006)
© 2006 American Board of Family Medicine

Clinical Review

Opioid Analgesics in Primary Care: Challenges and New Advances in the Management of Noncancer Pain

Raymond Sinatra, MD, PhD

From Yale University School of Medicine, New Haven, CT

Correspondence: Corresponding author: Raymond Sinatra, MD, PhD, Professor of Anesthesiology, Director, Pain Management Service, Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510 (E-mail: raymond.sinatra{at}yale.edu)

Primary care attitudes affecting the use of strong opioids in pain management have changed considerably in the last 3 decades. Forces that have shaped current attitudes and trends in opioid prescribing include historical influences, regulatory factors, and technologic and scientific advances. The article identifies for primary care physicians the current challenges and issues surrounding the use of opioid analgesics for noncancer pain and examines how new technology and expanding knowledge have been applied to existing opioids such as morphine, oxymorphone, and fentanyl to address continuing challenges in pain management.


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