title: Principles of opioid use in cancer pain.
abstract: The management of pain is an essential aspect of comprehensive cancer care. Positive outcomes can be achieved in most patients with widely available therapies. There is a broad consensus that opioid-based pharmacotherapy is the first-line strategy for the treatment of moderate or severe chronic pain in populations with active disease, and treatment guidelines have been developed from the known pharmacology of these drugs, extant data, and extensive clinical experience. This article describes the major opioid analgesics available for the treatment of cancer-related pain and reviews the key elements for safe and effective prescribing, including selection of the best drug and route, approaches to titration and long-term administration of baseline and supplemental doses, rotation from one drug to another in poorly responsive patients, and management of opioid risks.
authors.affiliation: All authors: Beth Israel Medical Center, New York, NY. rporteno@chpnet.org.
authors.forename: Russell K
authors.initials: RK
authors.lastname: Portenoy
authors.affiliation: All authors: Beth Israel Medical Center, New York, NY.
authors.forename: Ebtesam
authors.initials: E
authors.lastname: Ahmed
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D004333:Drug Administration Routes; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid