The prescription of opioid medications to treat chronic non cancer pain (CNCP) has increased substantially in the past years.1 To ensure adequate treatment outcomes and reduce the risks linked with the chronic use of opioids, French recommendations were developed.2–4 This study evaluated physicians adherence to these recommendations.

A questionnaire was mailed to a random sample of 150 general practitioners (GPs) practicing in one of the following French regions: Alsace, Bourgogne, Champagne-Ardenne, Franche-Comté and Lorraine. Outcome measures were adherence of physicians to current guidelines.

Forty-six responses were received. Respondents' mean age was 51.0 years and 72% were men. Seventy percent of GPs used pain scales to assess patient's pain intensity and up to 90% suggested to patients non-pharmacological approaches. Despite these good practices, only 25% of GPs assessed the risk of opiate addiction and numerous GPs prescribed opiates in non-recommended indications, including: migraine pain (82%), pure psychogenic pain (30%), fibromyalgic pain (72%) etc. In addition, 74% considered having received none or insufficient pain management education in medical school.

The present study identified that most physicians do not adhere with all French pain guidelines that has implications for patient care and the health care system. Thus, this study suggests a need for guidelines more practical to physicians and further education of physicians in the appropriate use of opioids to treat CNCP.