Pancreatitis

Recommendation ID: NG104/3
Question: Pain management: chronic pancreatitis:- Is the long-term use of opioids more clinically effective and cost effective than non-opioid analgesia (including non-pharmacological analgesia) in people with chronic pain due to chronic pancreatitis?
Any explanatory notes (if applicable): Why this is important:- Chronic pancreatitis is a complex condition needing biopsychosocial management. The pain is varied in nature, intensity, duration and severity, along with acute exacerbations. It is also multifactorial, making it difficult to have a standard regimen that can work for everyone. Some people also develop psychosocial factors such as reduction in quality of life, relationship issues, addiction to painkillers and financial difficulties.
Chronic pancreatitis is usually managed pharmacologically with a combination of opioids and other interventions. However, the use of opioids in managing chronic pancreatitis is known to cause serious side-effects – including tolerance, addiction, tiredness and constipation. These side-effects are frequently worse than the disease itself. Therefore, the whole rationale for the use of opioids in chronic pancreatitis is questionable. A cohort study is needed to determine how effective longterm opioid use is in this population compared with non-opiate pain management strategies, including analgesia and psychological therapies.

Source guidance details

Is this a recommendation for the use of a technology only in the context of research?	No
Is it a recommendation that suggests collection of data or the establishment of a register?	No
Last Reviewed	30/09/2018