Complications of opioids and nonsteroidal antiinflammatories in chronic nonmalignant pain

Chronic pain patients often require maintenance medication for ongoing symptom relief. Two of the most common classes of drugs used in this setting are opioids and nonsteroidal antiinflammatories. Both types of medication are being prescribed with increasing frequency and consequently complications and side-effects are being encountered more often. A role for opioids is beginning to emerge in the chronic benign pain patient population. Choosing appropriate patients, setting ground rules for medication use, and being aware of potential problems are all critical in minimizing complications. Nonsteroidal antiinflammatories are used both with and without physician supervision. The consumption of these medications is widespread despite potentially serious complications. Awareness of the pitfalls encountered with these medications should lead to safer outcomes and increased physician and patient satisfaction.