ABSTRACT
Drugs that treat pain are known as analgesics. It would be very simple if all analgesics relieved all types of pain. Some analgesics work directly on a pain. Opioids are the largest group of direct analgesics used in palliative care and examples are weak opioids, such as codeine, and strong opioids, such as morphine. Low doses of weak analgesics are gradually increased and then changed to stronger analgesics. These adjustments are known as titration and allow analgesics to be adjusted to each individual. Patients prefer to take analgesics by mouth rather than by injection or suppository. The standard 'analgesic staircase' only applies to pain that responds to opioids like morphine or codeine. In reality, pain can have many causes, and several pains can co-exist, sometimes in the same site. In severe pain in cancer, we usually start with opioids since several pains are often present together and one of these is commonly opioid-sensitive.
