October 2026 in Pain Management: 4 Updates on Treatment and Pharmacy Practice

October 2026’s Pharmacy Times pain management coverage focused on what happens beyond the initial prescription. Postoperative research examined whether reduced opioid prescribing accompanies satisfactory recovery, while cancer pain articles explored how follow-up and adverse-effect prevention support continued treatment. Contributor perspectives also addressed how public messaging about illicit fentanyl can influence patients’ willingness to use prescribed opioids.^1-4

For pharmacists, these articles connect evidence interpretation with practical patient care. Here are 4 updates from throughout the month worth revisiting.

Suzetrigine Findings Connect Opioid Stewardship With Recovery

An analysis of suzetrigine after knee replacement examined a retrospective evaluation involving 104 patients undergoing primary or revision knee arthroplasty. Patients receiving suzetrigine within multimodal care were more likely to avoid an opioid refill at or before the 2-week visit than historical controls (57.7% versus 34.6%). They were also more likely to be opioid-free at 6 weeks (88.5% vs 65.4%).¹

Pain scores and functional recovery did not differ significantly between groups. However, the historical comparison cannot establish causation, and prescribing records do not precisely measure medication consumption. The evaluation also did not establish a reduction in opioid-related adverse events.¹

For pharmacists, the findings reinforce the importance of assessing recovery alongside prescribing outcomes. Implementation also requires reviewing suzetrigine’s drug interactions and resolving coverage before surgery so patients can obtain the planned regimen when they need it.¹

Cancer-Related Neuropathic Pain Requires Purposeful Follow-Up

Coverage of pharmacist-supported mirogabalin treatment highlighted both an encouraging signal and important limitations. The retrospective study included 85 adults with malignancy, including 18 who received pharmacist-led recommendations and management.²

Among evaluable records, documented subjective improvement occurred in 13 of 13 patients receiving pharmacist-supported care versus 36 of 52 patients without pharmacist recommendation. When unevaluable records were retained in a conservative sensitivity analysis, the difference was no longer statistically significant. Missing data and the nonrandomized design limit conclusions about treatment benefit.²

The authors also emphasized that cancer-related nerve pain should not automatically be treated as chemotherapy-induced peripheral neuropathy. Pharmacists can help clarify the likely cause, assess functional changes, and review tolerability. When gabapentin or pregabalin is combined with opioids, monitoring for sedation and respiratory depression remains particularly important.²

Constipation Prevention Belongs at the Start of Cancer Pain Treatment

Coverage on cancer pain-associated constipation emphasized that bowel management should begin when opioid therapy starts. Because patients generally do not develop tolerance to opioids’ effects on intestinal transit, waiting for troublesome symptoms leaves a predictable complication unaddressed.³

The coverage outlined scheduled stimulant laxative use and reassessment according to bowel function. Pharmacists should establish a baseline bowel pattern and distinguish preventive treatment from rescue medication, with clear instructions about when to contact the oncology team.³

Persistent constipation requires assessment of what the patient actually took and whether additional causes are contributing. Abdominal distention with vomiting or inability to pass gas or stool warrants urgent evaluation rather than automatic escalation of OTC treatment. Rectal products also require caution in patients with neutropenia or thrombocytopenia.³

Opioid Counseling Must Address Fear Without Minimizing Risk

A contributor article on supporting patients prescribed opioids examined how messaging about illicit fentanyl can create uncertainty for patients receiving medically supervised pain treatment. Some patients may delay or avoid prescribed medication because they associate all opioid use with overdose or addiction.⁴

The authors encouraged pharmacists to acknowledge those concerns and explain the differences between illicit products and regulated medications used within an individualized treatment plan. That distinction should accompany discussion of the risks that remain with prescribed opioids.³

Practical counseling includes offering naloxone, reviewing safe storage, and discussing interactions with alcohol or other central nervous system depressants. Explaining that physical dependence is distinct from addiction can also help patients ask questions without embarrassment. An open conversation gives pharmacists an opportunity to identify undertreated pain or unsafe medication use before either becomes a larger problem.³

REFERENCES

1. Kariyawasam-Chavez R. Suzetrigine after knee replacement: are fewer opioid prescriptions enough? Pharmacy Times. October 5, 2026. Accessed October 30, 2026. https://www.pharmacytimes.com/view/suzetrigine-after-knee-replacement-are-fewer-opioid-prescriptions-enough-

2. Kariyawasam-Chavez R. Managing cancer-related nerve pain: where pharmacist follow-up fits. Pharmacy Times. October 22, 2026. Accessed October 30, 2026. https://www.pharmacytimes.com/view/managing-cancer-related-nerve-pain-where-pharmacist-follow-up-fits

3. Kariyawasam-Chavez R. Cancer pain relief starts with a constipation plan. Pharmacy Times. October 27, 2026. Accessed October 30, 2026. https://www.pharmacytimes.com/view/cancer-pain-relief-starts-with-a-constipation-plan

4. Krichbaum M, Ahmed E, Parker K. Supporting patients prescribed opioids in the era of “Fentanyl Free America.” Pharmacy Times. October 14, 2026. Accessed October 30, 2026. supporting-patients-prescribed-opioids-in-the-era-of-fentanyl-free-america-