Underuse of opioids in malignant pain

Jelena Raguž, Petra Vuković, Iva Marinčić, Nikolina Vincelj, Jakov Vuković

Malignant pain is a form of chronic pain experienced by a large number of oncology patients. It can be treated
with various drugs. WHO recommends the use of opioids for all patients who can't control their pain with a
combination of non-opioid and an adjuvant analgetic.

The goal of the reaserch was to determine the use of opioids in metastatic cancer patients and the quality of their
pain control.

The research included 72 patients with metastatic cancer at the University hospital for tumors in Zagreb. Most of
the examinees had multiple metastases. They filled out a questionnare consisting of various questions about their
pain and analgetic therapy.

Out of the total number of examinees, 68,9% had experienced disease related pain in the past month. 41,1%
answered they have pain daily. 38,5% of them estimated their pain on average 5-6 on the VAS scale. 48,23% of
patients take only NSAID or paracetamol for their pain. 26,92% use a combination of NSAID and a mild opioid,
7,7% use a strong opioid and 17,3% of patients don't use any analgetic drugs. Finally, 45,1% of all exminees
answered they don't thnk their pain is under control with their current pain medication.

Our research showed that the use of opioids among cancer patients is still inadequate wich leads to insufficient
pain control and a drop in the quality of life. The reason for that might be the fear of opioid dependance and all
the risks that the use of opioids carries. To overcome that fear, we must work on educating the whole medical
staff aswell as the patients and their families on the risks and benefits of opioid treatment.