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Opioids in palliative care 

Opioids in palliative care
Chapter:
Opioids in palliative care
Author(s):

Joan Hester

DOI:
10.1093/med/9780198834359.003.0018
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date: 05 December 2020

Before Twycross published the paper discussed in this chapter, the use of opioids in palliative care was more folkloric than evidence based, relying on the wisdom of the ages rather than being observation based: patients with advanced cancer received little or no narcotic (opioid) analgesics because of fears of addiction, of rapid escalation in dose, and of impairment of mental faculties. This paper, published in 1975, was instrumental in questioning some of the myths that had surrounded the dark art of opioid use, and expounding a rational and practical treatise for their use in palliative care. Although it describes an era over 40 years ago, when practice was markedly different from that used today, it also introduced concepts that were ahead of their time, such as the psychosocial aspects of pain.

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