A Narrative Approach to the Evolution of Chronic Pain Management: From Opioids to Non Pharmacological Therapies
Keywords:
Chronic Pain Management, Opioid Alternatives, Non Pharmacological Therapy, Multimodal Pain Strategies, Policy and Regulation, Health Equity, Patient Centred CareAbstract
Chronic pain remains a major global health concern, often managed through opioid based treatments despite mounting evidence of their limited long term effectiveness and associated risks. This narrative review aimed to synthesise two decades of evidence on the transition from opioid centric pain management to multimodal, non-pharmacological strategies. A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar, focusing on studies from 2005 to 2025. The review examined the comparative effectiveness of opioid and non-opioid therapies, implementation challenges, economic implications, and policy responses across various health systems. Findings suggest that while opioids may offer short term relief, their prolonged use leads to dependency, adverse effects, and diminishing returns. In contrast, cognitive behavioural therapy, mindfulness, and physical rehabilitation demonstrate substantial efficacy in pain reduction, functional improvement, and quality of life enhancement. Countries with robust regulatory frameworks and universal health coverage have shown greater success in implementing non pharmacological care models, whereas low resource settings face significant barriers. The review underscores the urgency of shifting toward integrated, patient centred approaches supported by policy, education, and system level reform. Future research should prioritise long term evaluation and context sensitive implementation models to ensure equitable access and improved outcomes.
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