Efficacy of Pain Management Among Opioid-Tolerant Individuals: An Integrative Review of the Literature

Abstract

Background: Opioids are among the most effective drugs for pain management. However, the course of pain management in opioid-tolerant individuals is complicated. An integrative literature review was conducted.

Objectives: The purpose of this integrative literature review is to establish the efficacy of using opioids to treat opioid-tolerant patients and the perspectives of patients and healthcare professionals.

Method: An integrative literature review was used along with Kolcaba’s comfort theory to determine common themes in the literature.

Findings/Results: The literature that was reviewed revealed that opioid-tolerant patients reported feeling as though their course of pain management was insufficient. Research has shown that prescribing opioids for chronic pain can induce hyperalgesia and stronger opioids will be needed for pain management; consequently, stronger opioids lead to more serious adverse effects. Additionally, healthcare professionals often hold detrimental views regarding treating this specific patient population in turn negatively affecting the care delivered.

Conclusions: This review found several factors that complicate the course of pain management in opioid-tolerant individuals. Findings highlight the importance of education of both healthcare professionals and patients in pain management of opioid-tolerant individuals. Suggestions for future guidelines are discussed.

Key Words: opioid, tolerance, efficacy, perspective, and pain management