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