Problems of legislative regulation and use of opioid analgetics in clinical practice
The problem of adequate pain control is especially significant when providing medical care to patients with intense chronic pain syndrome (CPS) when it is necessary to use opioid analgesics (OA) and, above all, those included in the group of narcotic drugs and psychotropic substances used under the strict state control. The article discusses the pain control strategy details presented in the amendments to the Federal Law 323-FL, analyzes the problems that prevent the adequate pain therapy in practical public health. The choice of rational pain control tactics using varied therapeutic approaches in various situations is substantiated; the place of morphine among the other OA is determined; the main OA which are applied today for CPS control characteristic is provided. It is emphasized that when choosing a particular OA and its dosage form the physician should be aware of the opioid tolerance and dependence occurrence which growth rate is related both to the characteristics of the OA itself and to its dosage form. Currently the legislation norms allow unimpeded OA administration for the patients in need and the list of drugs used can provide adequate pain control in most cases but the scale of OA non-medical use in foreign countries makes it necessary to be extremely careful in choosing the drugs to avoid any possible mistakes.