Palliative care for adults: strong opioids for pain relief

National Institute for Health and Care Excellence



  • When offering pain treatment with strong opioids to a patient with advanced and progressive disease, ask them about concerns such as:
    • addiction
    • tolerance
    • side effects
    • fears that treatment implies the final stages of life
  • Provide verbal and written information on strong opioid treatment to patients and carers, including the following:
    • when and why strong opioids are used to treat pain
    • how effective they are likely to be
    • taking strong opioids for background and breakthrough pain, addressing:
      • how, when and how often to take strong opioids
      • how long pain relief should last
    • side effects and signs of toxicity
    • safe storage
    • follow-up and further prescribing
    • information on who to contact out of hours, particularly during initiation of treatment
  • Offer patients access to frequent review of pain control and side effects

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