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Opioids: Should Tolerance Affect our Management? - page 42 / 46

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Reasons not to Escalate Opioids

Lack of opioid escalation does not mean lack of tolerance development

Side effects, fear of “addiction”, cost, etc.

Portenoy and Foley, Pain 25:171, 1986

- 38 non-cancer patients, chart reviews

- most patients treated on opioids for >2yrs

- over 50% of patients < 20 mg MS

- 14 of 38 reported inadequate pain relief

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