2b Opioids in chronic pain

The majority of patients with cancer pain need therapy including strong opioids, and patients with non-cancer pain may also benefit from strong opioid medication. This review analyses the efficacy of an opioid therapy comparing different substances and routes of administration. It is shown how, with an adequate choice of medication and mode of administration, opioid therapy may have a low incidence of side-effects and provide a high level of safety. Today, oral medication with sustained-release morphine at a given interval is regarded as the ‘golden standard’ for chronic pain therapy. An alternative may be transdermal fentanyl, but further controlled trials are necessary.