Part 6 - Why Is Cancer Pain So Special?

by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 5th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Another Hand-Crafted GraphPart 4 – Everything We Were Taught About High Doses Was Wrong, And The Same Hand-Crafted GraphPart 5 – Why Do We Lump The Non-Cancer Pain Syndromes Together?This is Part 6, which asks the sort of inverse question toPart 5– Why Is Cancer Pain So Special?Why is cancer pain, in so many guidelines and organizational/public policies ‘exempted’ from the dosing and safety guidelines. This is not a rhetorical question – I have not actually ever read a coherent explanation as to why.One might reasonably assume there ’s all this research demonstrating the safety and efficacy of long-term opioid use in cancer patients. In reality, that research is non-existent.Guidelines like the CDC ’s accurately point out that there are essentially no data demonstrating the long term efficacy of opioids for &lsquo...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: cancer opioids pain rosielle The profession Source Type: blogs

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