Chronic pain is defined as pain which is experienced for longer than 3 months (not including palliative care). 

According to NICE guidance, first line shouldn’t be pharmacological treatments such as paracetamol, non-steroidal anti-inflammatories (NSAIDS), opioids, benzodiazepines and z-drugs (zopiclone and zolpidem) as well as some others. If patients are on these medicines, they can be tapered down and eventually stopped. 

Cognitive behavioral therapy (CBT), acceptance commitment therapy (ACT) and acupuncture, if appropriate, are more suitable.  

Pharmacological treatment such as antidepressants should be considered, if appropriate.  

However, Royal Pharmaceutical Society and Faculty of Pain Medicine of the Royal College of Anesthetics have argued that there are concerns over this guidance particularly over the terminology of chronic primary pain which could result the guidance “not being fit for purpose”. 

For more information, see NICE guidance https://www.nice.org.uk/guidance/ng193/chapter/Recommendations 

And pharmaceutical journal article https://pharmaceutical-journal.com/article/news/deep-concern-over-not-fit-for-purpose-draft-nice-guidance-on-chronic-pain