Abstract
Therapeutic use of opioids is dependent on factors such as affinity, agonism, and safety profile and guided by morphine milligram equivalent dose. Exposure to opioids in acute pain and perioperative setting is associated with complications such as respiratory depression, urinary retention, hyperalgesia, and prolonged use after surgery. Current guidelines recommend multimodal analgesia with a limitation of opioid use under these conditions. Opioids form an integral part of three-step analgesic care in cancer pain. However, opioid use in noncancer chronic pain increased threefold between 1999 and 2015, with an associated increase in overdose-related deaths and complications such as injuries and neonatal opioid withdrawal syndrome. Guidelines on the safe use of opioids in chronic pain and opioid agonist treatment for opioid dependence are being promoted as countermeasures. Nonmedical use of prescription and illicit opioids continues to be a major problem globally.
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