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Special article| Volume 10, ISSUE 8, P632-638, November 1995

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Opioid use in advanced malignant disease: Why do different centers use vastly different doses? A plea for standardized reporting

  • Marcel Boisvert
    Correspondence
    Address reprint requests to: Marcel Boisvert, MD, Palliative Care Service, Royal Victoria Hospital, 687 ave des Pins Ouest, Montréal, Quebec, H3A 1A1, Canada.
    Affiliations
    Palliative Care Service (M.B.), Royal Victoria Hospital, and Division of Palliative Care Medicine (M.B., S.R.C.), Department of Oncology, McGill University, Montreal, Quebec, Canada
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  • S.Robin Cohen
    Affiliations
    Palliative Care Service (M.B.), Royal Victoria Hospital, and Division of Palliative Care Medicine (M.B., S.R.C.), Department of Oncology, McGill University, Montreal, Quebec, Canada
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      Abstract

      This paper reviews several recent publications concerning the use of opioids to control cancer pain and highlights the wide variation in mean daily dose. Present methods of reporting do not provide an explanation for these widely different doses used. It is essential that we understand the circumstances in which high doses are required, as higher doses are associated with greater toxicity and higher cost. Several factors that may influence the dose of opioid required are discussed. It is suggested that reporting of cancer pain, patient population, pharmacological and nonpharmacological interventions, and toxicity be standardized to allow for rational guidelines to be established for opioid use in pain due to advanced cancer.

      Keywords

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