title: Use of Opioids in Latin America: The Need of an Evidence-Based Change.
abstract: OBJECTIVE
  The subject of this publication has been focused on local considerations for facilitating regional best practice, including identifying and uniformly adopting the most relevant international guidelines on opioid use (OU) in chronic pain management.
  
  
  METHODS
  The Change Pain Latin America (CPLA) Advisory Panel conducted a comprehensive, robust, and critical analysis of published national and international reviews and guidelines of OU, considering those most appropriate for Latin America.
  
  
  METHODS
  A PubMed search was conducted using the terms "opioid," "chronic," and "pain" and then refined using the filters "practice guidelines" and "within the last 5 years" (2007-2012). Once the publications were identified, they were selected using five key criteria: "Evidence based," "Comprehensive," "From a well-recognized source," "Current publications," and "Based on best practice" and then critically analyzed considering 10 key criteria for determining the most relevant guidelines to be applied in Latin America.
  
  
  RESULTS
  The initial PubMed search identified 177 reviews and guidelines, which was reduced to 16 articles using the five preliminary criteria. After a secondary analysis according to the 10 key criteria specific to OU in Latin America, 10 publications were selected for critical review and discussion.
  
  
  CONCLUSIONS
  The CPLA advisory panel considered the "Safe and effective use of opioids for chronic non-cancer pain" (published in 2010 by the NOUGG of Canada) to be valid, relevant to Latin America, practical, evidence-based, concise, unambiguous, and sufficiently educational to provide clear instruction on OU and pain management and, thus, recommended for uniform adoption across the Latin America region.
authors.affiliation: *Facultad de Medicina Clínica Alemana/Universidad del Desarrollo, Santiago, Chile mrico@alemana.cl.
authors.forename: María Antonieta
authors.initials: MA
authors.lastname: Rico
authors.affiliation: Clínica del Dolor y Departamento de Anestesiología y Cirugía de la Universidade Federal da Bahia, Brazil.
authors.forename: Durval Campos
authors.initials: DC
authors.lastname: Kraychete
authors.affiliation: Unidad de Rehabilitación del Hospital Central de Maracay, Venezuela.
authors.forename: Aziza Jreige
authors.initials: AJ
authors.lastname: Iskandar
authors.affiliation: Medicina del Dolor y Cuidados Paliativos, Clínica el Rosario, Medellín, Colombia.
authors.forename: Frantz
authors.initials: F
authors.lastname: Colimon
authors.affiliation: Clínica del Dolor y Cuidados Paliativos, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, DF, Mexico.
authors.forename: Argelia
authors.initials: A
authors.lastname: Lara-Solares
authors.affiliation: **Centro Médico Hidalgo, Monterrey, Mexico.
authors.forename: José Alberto Flores
authors.initials: JA
authors.lastname: Cantisani
authors.affiliation: Hospital Ángeles Tijuana, Tijuana, Mexico.
authors.forename: César
authors.initials: C
authors.lastname: Amescua-García
authors.affiliation: Clínica del Dolor, Instituto Nacional de Cancerología, Mexico, DF, Mexico.
authors.forename: María del Rocío Guillén
authors.initials: Mdel R
authors.lastname: Núñez
authors.affiliation: Instituto de Oncología Dr Luis Razetti, Caracas, Venezuela.
authors.forename: Patricia
authors.initials: P
authors.lastname: Bonilla
authors.affiliation: Servicio de Ortopedia, Instituto de Ortopedia e Traumatologia, Hospital Sao Vicente de Paulo, Passo Fundo, Brazil.
authors.forename: Osvandré
authors.initials: O
authors.lastname: Lech
authors.affiliation: ***Unidad de Neurociencias de la Universidad del Rosario, Centro de Cuidados Paliativos y Medicina del Dolor en Hospital Universitario Mederi, Bogotá, Colombia.
authors.forename: John Jairo
authors.initials: JJ
authors.lastname: Hernández-Castro
authors.affiliation: Departamento de Anestesia y Clínica de Dolor, Hospital Universitario Fundación Santa Fe de Bogotá, Colombia.
authors.forename: Carlos
authors.initials: C
authors.lastname: Guerrero
authors.affiliation: Clínica de Diagnóstico y Tratamiento del Dolor, Hospital Clínica Biblica, Costa Rica.
authors.forename: William Delgado
authors.initials: WD
authors.lastname: Barrera
authors.affiliation: Facultad de Ciencias de la Salud de la Universidad Tecnológica Equinoccial, Clínica del Dolor Hospital Metropolitano, Quito, Ecuador.
authors.forename: Manuel Sempértegui
authors.initials: MS
authors.lastname: Gallegos
authors.affiliation: Departamento de Dolor y Cuidados Paliativos, TotalCare-Oncosalud-Auna, San Borja-Lima, Peru.
authors.forename: María Berenguel
authors.initials: MB
authors.lastname: Cook
authors.affiliation: ****Departamento de Anestesiología, Dolor y Cuidados Paliativos de la Universidad Federal do Maranhao (UFMA), Brazil.
authors.forename: João Batista Santos
authors.initials: JB
authors.lastname: Garcia
authors.affiliation: Hospital Universitario de la Princesa, Madrid, España.
authors.forename: Concepción Pérez
authors.initials: CP
authors.lastname: Hernández
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D007843:Latin America; D059408:Pain Management / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic Pain; Latin America; Opioid Barriers; Opioids Guidelines