Balancing the availability of opioids—the pendulum is swinging again (Editorial)

open access: Balancing the availability of opioids—the pendulum is swinging again 

 For cancer pain, strong opioids are frequently required and there is good evidence to support their use. The general rule is to titrate doses until either pain relief is achieved or adverse effects become intolerable. There is no good evidence to support the notion that cancer patients will become addicted to these drugs but doses will probably increase as the tumour progresses. The tragedy is that fear of addiction has led many developing countries to severely restrict opioids so that in practice they are either not available or only available in sub therapeutic doses. Such an approach, in my view, is morally indefensible.