Clinical Aspect of Narcotics for Medical Use

In recent years, narcotics for medical use (NMU) have been used for patients with non-cancer neuropathic pain. NMU are classified as the third stage drugs according to “Guidelines for the pharmacologic management of neuropathic pain” edited by the Japan Society of Pain Clinicians. NMU which are indicated only for cancer pain (Ex: fentanyl patch) have come to be used for non-cancer neuropathic patients, therefore the frequency of NMU use can be expected to increase in the future. Although NMU including oxycodone, morphine and fentanyl have been reported to be effective for patients with non-cancer pain in foreign literature, none have been approved for non-cancer pain by Japanese health insurance. We should consider screening patients before prescribing NMU to determine the risk of abuse and should conduct sufficient follow up while prescribing them. On the other hand, patients prescribed NMU may wish to travel abroad for sightseeing, so physicians who prescribe NMU should be aware of official procedures for going abroad while carrying NMU.