Will the number of milligrams of an opioid dose ever re-achieve the truly meaningless status it deserves? Journal Article


Authors: Passik, S. D.; Kirsh, K. L.
Article Title: Will the number of milligrams of an opioid dose ever re-achieve the truly meaningless status it deserves?
Abstract: There is a notion that tolerance is an inevitable complication when patients are maintained on opioid analgesic regimens for an extended period of time. Whether this is true or not, it is important to remember that, in spite of growing regulatory scrutiny and spreading fear around these medications, defining "ceiling doses" of opioids has more to do with clinician comfort and much less to do with reality and patient requirements. This commentary posits that clinicians must return to the principles of balancing efficacy with toxicity as the dose-limiting factor once again, contextualized by outcomes in the areas of function and compliant drug-taking. Copyright © by The Haworth Press, Inc. All rights reserved.
Keywords: adult; review; drug efficacy; drug safety; drug withdrawal; unspecified side effect; cancer patient; drug megadose; outcome assessment; pain; opiate; palliative therapy; cancer pain; dose-response relationship, drug; prescription; patient compliance; medical practice; medicolegal aspect; drug dose titration; analgesics, opioid; opioid; substance-related disorders; drug dose increase; drug dose regimen; analgesia; pain assessment; drug tolerance; drug use; pain threshold; tolerance; oxycodone; drug urine level; low back pain; opiate addiction; dose; addiction; cannabis; sustained drug release
Journal Title: Journal of Pain and Palliative Care Pharmacotherapy
Volume: 21
Issue: 1
ISSN: 1536-0288
Publisher: Haworth Press Inc  
Date Published: 2007-03-01
Start Page: 39
End Page: 41
Language: English
DOI: 10.1300/J354v21n01_09
PUBMED: 17430829
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 17 November 2011" - "CODEN: JPPCB" - "Source: Scopus"
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  1. Steven D Passik
    122 Passik