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Should opioids be used for chronic non-cancer pain?

Dilip Kapur, Phillip B Cornish, Carol A Snellgrove and David A Cherry
Med J Aust 2011; 195 (9): . || doi: 10.5694/mja11.11127
Published online: 7 November 2011

To the Editor: We write in response to the letter by Awerbuch1 and agree with many of his points. He has raised an interesting issue regarding the assertion that chronic pain is itself a disease,2 suggesting it would then logically follow that the patient becomes the final arbiter of whether he or she has the “disease” and hence which treatment may or may not be appropriate.


  • Pain Management Unit, Flinders Medical Centre, Adelaide, SA.



Competing interests:

No relevant disclosures.

  • 1. Awerbuch MS. Should opioids be used for chronic non-cancer pain [letter]? Med J Aust 2011; 195: 264-265. <MJA full text>
  • 2. Siddall PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg 2004; 99: 510-520.
  • 3. International Association for the Study of Pain. Declaration of Montréal. Declaration that access to pain management is a fundamental human right. Approved October 2010. http://www.iasp-pain.org/Content/NavigationMenu/Advocacy/DeclarationofMontr233al/default.htm (accessed Sep 2011).
  • 4. Hall WD, Farrell MP. Minimising the misuse of oxycodone and other pharmaceutical opioids in Australia [editorial]. Med J Aust 2011; 195: 248-249. <MJA full text>
  • 5. Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med 2010; 363: 1981-1985.

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