Chronic pain is usually treated with pharmacological measures using opioids alone or in combination with adjuvant analgesics
that play an important role in the treatment of pain not fully responsive to opioids administered alone, especially in neuropathic, bone and
visceral colicky pain. The important part of the chronic pain treatment is the appropriate use of non-pharmacological measures along with
psychosocial and spiritual support.
Opioids may be administered by different routes; the most common and most convenient for majority of treated patients are oral and
transdermal. However, in certain circumstances such as inability to swallow, lack of analgesic efficacy and intractable opioid-induced
adverse effects parenteral routes (subcutaneous, intravenous) might be more useful. When these routes fail, in some patients intrathecal
administration of opioids is required. Recently, more patients have been treated with short-acting opioids for breakthrough pain with sublingual,
buccal and intranasal routes of opioid administration that may provide efficacy superior to oral and comparable to intravenous
routes. Alternative routes comprise rectal, inhaled and topical administration of opioids. This article discusses various routes of opioid
Keywords: Analgesics, cancer pain, chronic pain, opioids, opioid delivery, pain treatment, routes of administration.
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