Palliative care for adults: strong opioids for pain relief (CG140)

 In Clinical Guidelines, NICE guidelines

This updated NICE guidance covers safe and effective prescribing of strong opioids for pain relief in adults with advanced and progressive diseases. It aims to improve pain management and patient safety.

The update in August 2016 deleted recommendation 1.1.12 and two out-of-date research recommendations. It also replaced the link to NICE’s guideline on Controlled Drugs NG46, which has newer advice on the topic.

The current recommendations are:

  • Communication.
  • Starting strong opioids and titrating the dose.
  • First-line maintenance treatment.
  • First-line treatment using transdermal patches or subcutaneous delivery, if oral opioids are not suitable.
  • First-line treatment for breakthrough pain in patients who can take oral opioids.
  • Managing constipation, nausea, and drowsiness.

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