Evaluation of an Opioid Decrease Strategy in Chronic

Evaluation of an Opioid Decrease Strategy in Chronic Pain Patients at the Pain Assessment and Treatment Center in Montpellier: Prospective Study Over 6 Months.

Increase in the consumption of analgesics observed in many countries with a mediatic crisis resulting in an increasingly frequent wish of patients to wean themselves from opiates. A recent update (B. Rolland 2017) suggests that upon initiation of an opioid analgesic treatment, the patient should be informed of the risk of opioid dependence and misuse. There is no clearly validated decay scheme in the event of dependence in patients with Chronic Non-Cancer Pain.

Hypotheses:

• Possibility of a rapid decrease in opioid analgesic treatments at DCNC sensitized to the risk of DOP and MOP. (Protocol implemented: Multidisciplinary assessment, workshops and information sheet on chronic pain, treatments and risk of DOP, pharmacological and nonpharmacological adaptation)
• Highlight the need for additional information from patients and prescribers on the risk of DOP and MOP in DCNC.

Main objective: Check if the rapid to semi-rapid regimen (- 25 to -60% dosage in 5 days of HDS) of opioid analgesics, without the use of methadone or buprenorphine agonists, in the case of DCNC at the CETD in Montpellier is efficient in the medium term (6 months).

Secondary objective:

• With our inclusion questionnaire we wanted to check if the patients had been made aware of the risk of opiate dependence and misuse.
• Detect the conditions of prescriptions that can promote the misuse of opiates.
• Evaluating the different components of residual pain at 6 months (type, intensity, anxiety component and depression, function).

Inclusion criteria:

• chronic pain patient
• major
• supported at CETD

Exclusion criteria:

-patient with physical and mental incapacity to participate in the study