title: An Overview of Pharmacologic Management of Chronic Pain.
abstract: Patients with chronic pain can be challenging to manage and historically providers have relied on opiates to treat pain. Recent studies have brought into question the safety and efficacy of chronic opiate therapy in the noncancer population. There is a vast amount of literature to support the use of nonsteroidal anti-inflammatory medications, antidepressants, anticonvulsants, topical agents, cannabinoids, and botulinum toxin either in conjunction with or in lieu of opioids. Intrathecal drug delivery systems can deliver some of these medications directly to their primary site of action while minimizing the side effects seen with systemic administration.
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego, San Diego, CA, USA.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Beal
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego, San Diego, CA, USA. Electronic address: mswallace@ucsd.edu.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Wallace
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use; D002186:Cannabinoids / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006801:Humans; D010147:Pain Measurement; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000928:Antidepressive Agents; D002186:Cannabinoids; D001905:Botulinum Toxins
keywords: Chronic pain; Evidence based; Intrathecal drug delivery; Neuropathic pain; Nonopiate pain medication; Pharmacologic management