Non-Opioid Pharmacologic Management of Chronic Pain: A Primer

Kevin A. Sevarino, MD, PhD
Medical Director, Newington Mental Health Firm
Connecticut VA Healthcare System
Assistant Clinical Professor
Yale University School of Medicine and 
University of Connecticut School of Medicine
Medical Director, Providers’ Clinical Support System for Opioid Therapies
June 20, 2014 

Chronic pain management is a common reason for primary care contacts and perhaps the issue raising the most anxiety in providers and patients on a daily basis.  From the early 1990s the primary approach for such pain management was the prescription of short- and long-acting opioids.  Unfortunately, the ensuing years have taught us pain management remains ineffective for many patients and chronic opioid use carries the burden of increased rates of adverse effects, including addiction, substance misuse, overdose deaths and hyperalgesia.

In the fast-paced world of primary care, clinicians have not had the same pressure or education to use non-opioids as was employed to encourage opioid use in the 1990s.  In this presentation we examine and compare non-opioid medications for pain management that may be used alone, as adjuncts to opioids, and/or in conjunction with non-pharmacologic modalities, to improve the life and function of the chronic pain patient.