Long-Acting and Short-Acting Opioid Analgesics for the Treatment of Chronic Pain: Selection and Use

Dan I. Silvershein, MD

Assistant Professor, Internal Medicine
Adjunct Professor
School of Nursing
New York University School of Medicine
New York, New York

Both long-acting and short-acting opioids can have a role in the long-term management of patients with chronic pain. Short-acting opioids, because of their onset of action, are well suited to the titration phase, as well as for use as rescue medication in patients with breakthrough pain. Long-acting opioids, because of their longer duration of action, may provide more stable pain control for some patients. There is however a dearth of evidence to demonstrate a difference in pain control or adverse events between long-acting opioids and around-the-clock therapy with short-acting opioids. The main goal is to achieve good pain control for the patient with minimal adverse events; both short-acting opioids and long-acting opioids may play a role in meeting the individual patients’ needs.

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