RESUMEN
The limited access to opioids remains a reality in developing countries. Recent evidence suggests that opioid epidemics are getting worse with the COVID-19 crisis. The increase in opioid abuse could be attributed to the extended lockdowns and the social distancing recommendations, hindering chronic pain patients' access to regular office visits and monitoring in addition to limited access to behavioral services like group therapies and other pain management interventions. Use of telemedicine as an alternative to in-person follow-up visits has faced many limitations due to technological challenges and cost. Chronic pain patients living in developing countries face extra burden during the pandemic. Limited access to outpatient clinics and hesitance to visit hospitals due to COVID-19 pandemic, in addition to reduction in supply of opioids, are some of the limiting factors. Unfortunately, the low-income class with limited financial capabilities faces further barriers to access the chronic pain services and treatments like opioid prescriptions. Medical entities involved in care of chronic pain patients have adopted different strategies to overcome these challenges. In addition to expanding on educational programs to medical staff and patients, modifying the strict opioid pre-scribing and dispensing regulations has been successful. Another positive trend has been the growing use of opioid sparing interventions, such as multimodal analgesia, regional blocks, and interventional pain procedures.