Opioids and treatment of chronic pain: understanding pain patterns and the role for rapid-onset opioids.

Chronic pain is a frequent medical condition that has a significant impact on patients, including their ability to function and enjoy life. In addition, chronic pain has a substantial economic impact on the workplace and costs of healthcare. Although not without controversy, opioids are effective in the treatment of noncancer chronic pain. Understanding the pattern of temporal variations in a patient's pain is important in developing an opioid-based treatment plan. By understanding those times of day and activities that may precipitate severe episodes of pain, tailored opioid treatment plans can be developed that manage pain, improve patient functionality, and minimize side effects. Recently developed rapid-onset opioid formulations should be considered as part of the chronic pain management strategy in addition to more traditional long-acting, sustained-release formulations and short-acting, normal-release formulations.