Opioids are not the drug of choice for chronic non-cancer pain, but in an appropriate clinical setting, oral opioids are currently considered an acceptable medical intervention for chronic benign painful conditions.
The prescription of opioids must meet current medical practice standards and all legal and regulatory requirements.
In the context of Workers' Compensation, long-term opioid prescription for chronic non-cancer pain should only be considered for treatment of an injured worker if: - prescription of opioids is not the first line of treatment; - prescription of opioids is part of an integrated approach to pain management; - there is a written treatment agreement between patient and physician; - there is a primary prescriber; - the route of prescription is oral; - behavioural symptoms that suggest opioids may increase the complexity of the injured worker's problem are carefully considered; - there is evidence that treatment with opioids results in improvement of both pain AND function, enabling the injured worker to return to work; and - there is appropriate oversight by the Workers' Compensation Board.