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right, and every healthcare system must ensure it. In this regard, great progress has been made with the implementation
of chronic pain in the revised ICD-11, which will contribute to changing health policy and focusing more attention on the
prevention and treatment of chronic pain worldwide. Integrative pharmacological and nonpharmacological therapeutic
approaches with the patient in focus (patient-centric approach) have the strongest evidence of effectiveness; because
they reduce not only the intensity of pain but also improve physical, psychological, and social functionality and increase
patient satisfaction. Individually tailored balanced pharmacological approaches for different phenotypes of chronic pain
(nociceptive, neuropathic, nociplastic) involve the use of nonselective and selective non-steroidal anti-inflammatory
drugs (NSAIDs), acetaminophen, antidepressants, anticonvulsants, other adjuvant therapies and opioid analgesics. These
pharmacological approaches based on mechanisms, intensity of pain, and comorbidities, contribute to the optimization
of individual therapeutic goals and the maximization of safety and quality of life of persons being treated. Liberalization
of opioid prescription in CNCP and inadequate selection and follow-up of patients have contributed to opioid prescription
reaching epidemic proportions in the USA, Canada, and some Western European countries and led to the phenomenon
of medicalization, iatrogenesis, and fatal outcomes, i.e. opioid crisis. The U.S. Centers for Disease Control (CDC, 2022)
guideline for opioid prescribing is summarized in 12 key recommendations based on strong evidence and related to
initiation of opioid therapy, opioid selection, dose determination, duration of therapy, monitoring, and assessment of
potential side effects from the use of opioids.

Keywords: chronic non-cancer pain, adults, pharmacotherapy

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44 DOI: 10.5937/Galmed2410035P