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Review
. 2025 Aug 11.
doi: 10.1007/s00540-025-03559-x. Online ahead of print.

Executive summary of the guideline for prescribing opioid analgesics for chronic non-cancer pain (third edition) by the Japan Society of Pain Clinicians

Akifumi Kanai  1 , Masako Iseki  2 , Hiroki Iida  3 , Shigeki Yamaguchi  4 , Ayano Oiwa  5 , Hiroshi Yonekura  6 , Narihito Iwashita  7 , Hiroshi Ueno  8 , Yoshiyuki Kimura  4 , Toshifumi Takasusuki  4 , Keisuke Yamaguchi  9 , Shie Iida  9 , Hiroko Ikemiya  2 , Rina Oya  8 , Yoko Sugiyama  3 , Kumiko Tanabe  10 , Ayano Taniguchi  11 , Yoshiyasu Hattammaru  5 , Maki Mizogami  3 , Shinobu Yamaguchi  12 , Keiko Yamada  2 , Sei Fukui  13
Affiliations
Review

Executive summary of the guideline for prescribing opioid analgesics for chronic non-cancer pain (third edition) by the Japan Society of Pain Clinicians

Akifumi Kanai et al. J Anesth. .

Abstract

Opioid analgesics are powerful pain relievers, but inappropriate use can cause a variety of problems. Especially, in chronic non-cancer pain, inappropriate use of opioid analgesics might fail to improve or even worsen the quality of life and activities of daily living of patients impaired by pain. The Japan Society of Pain Clinicians has developed the Guidelines for Prescribing Opioid Analgesics for Chronic Non-cancer Pain (Third Edition), which answers basic clinical questions concerning opioid management as summary statements in accordance with the most recent scientific evidence and expert opinion. The guidelines emphasize patient selection (e.g., obvious organic cause of the persistent pain, low risk of psychosocial factors, pain refractory to non-opioid therapies, and good adherence to medication). Furthermore, patients should be treated with an oral dose of 90 morphine milligram equivalents/day as the upper limit and target duration of 3-6 months. For pain in cancer survivors that is not directly caused by cancer, such as pain after treatment or pain associated with complications or pre-existing conditions, these guidelines should be followed.

Keywords: Chronic pain; Japanese guideline; Non-cancer pain; Opioid analgesics.

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References

    1. Minds Manual Developing Committee. Minds manual for guideline development 2020 ver. 3.0. Tokyo: Japan Council for Quality Health Care; 2021. https://minds.jcqhc.or.jp/s/manual_2020_3_0 . Accessed 01 Aug 2025.
    1. Aihara M. GRADE system for clinical practice guideline, third edition (in Japanese). Tokyo: Chugai Igakusha; 2018.
    1. Fukuda K. Opioid analgesics. In: Miller RD, editor. Miller’s anesthesia. 8th ed. Elsevier; 2014. p. 864–914.
    1. World Health Organization. WHO guideline for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. 2019. https://www.who.int/publications/i/item/9789241550390 Accessed 01 Aug 2025.
    1. Ministry of Health, Labour and Welfare. Guidance for the appropriate use of medical narcotics: Guidance on the use and management of narcotics in cancer pain treatment (in Japanese). https://www.mhlw.go.jp/content/11120000/001245820.pdf . Accessed Dec 2024.

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