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Opioid Sensitivity of Chronic Noncancer Pain

Eija Kalso, Henry J McQuay, Zsuzsanna Wiesenfeld-Hallin (Eds.). IASP Press, 1999. 397 pages. $68.00 (US) member price: $44.20 (US). ISBN 0-931092-28-0

Halifax, Nova Scotia

This multi-authored book is based on the first international research symposium of the International Association for the Study of Pain (IASP) held in Finland in late 1998. This book covers extensively the known and proposed mechanisms of action of opioids, whilst the therapeutic evaluation and clinical use of opioids is covered in lesser detail. A special emphasis of the book is to explore the issue of opioids and neuropathic pain.

This book is divided into four parts, Part I deals with the function and dysfunction of opioid receptors, Part II outlines the clinical pharmacology of opioids, Part II provides new perspectives on the sensitivity of opioids and Part IV gives insight into the clinical use of opioids in neuropathic, inflammatory, ischemic and chronic musculoskeletal pain as well as in headache. Part IV is of particular use to the clinician who cares for the patient with chronic non-cancer pain.

This book provides an excellent review of the current status of basic research of the opioids. The issues of opioid responsiveness and the influence of duration or severity of chronic pain on opioid sensitivity in different types of pain are addressed in detail along with the concept that long-lasting pain may induce phenotypic changes in expression of many neuroactive substances and receptors.

A key objective of the symposium, and thus this book, was to establish the evidence of opioid efficacy in chronic non-cancer pain. This book accomplishes this objective admirably and is worthy of review by both clinicians and researchers.

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