Treating chronic pain: the need for non-opioid options

Expert Rev Clin Pharmacol. 2014 Sep;7(5):545-50. doi: 10.1586/17512433.2014.928587. Epub 2014 Jun 11.


Chronic pain is a prevalent problem that exacts a significant toll on society. The medical system has responded to this issue by implementing pain management services centered on opioid pharmacotherapy. However, for many chronic pain patients, the analgesic efficacy of long-term opioids is limited. Moreover, chronic exposure to opioids can result in opioid misuse, addiction, and risk of overdose. As such, non-opioid treatment options are needed. This article first provides a selective review of cognitive, affective, and psychophysiological mechanisms implicated in chronic pain to be targeted by novel non-opioid treatments. Next, it briefly details one such treatment approach, Mindfulness-Oriented Recovery Enhancement, and describes evidence suggesting that this intervention can disrupt the risk chain linking chronic pain to prescription opioid misuse.

Keywords: addiction; chronic pain; mindfulness; neurocognitive; opioid misuse.

Publication types

  • Editorial
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Chronic Pain / etiology
  • Chronic Pain / physiopathology
  • Chronic Pain / therapy*
  • Drug Overdose
  • Humans
  • Mindfulness / methods*
  • Opioid-Related Disorders / prevention & control
  • Prescription Drug Misuse / adverse effects
  • Time Factors


  • Analgesics, Opioid