Opioids, pain, and fear

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Abstract
Cancer pain has been described as ‘total pain’ presenting physical, psychological, social, and spiritual components [1], and can thus be defined as a ‘biopsychosocial experience’ [2]. It is very difficult to identify the specific ‘percentage’ of each of these components for a given value in a numerical scale of pain assessment although it has been reported that emotional and cognitive components seem to be proportionally more important in cancer pain than in noncancer pain [3]. As cancer pain is a multifactorial experience and is present together with numerous other symptoms, pain management within the context of palliative care plays an important role in the systematic control of symptoms [4]. In fact, global and continuous palliative interventions in patients bring about a substantial reduction in the dose of opioids used for cancer pain management [5]. Cancer pain must therefore be dealt with using a global approach which obviously includes the correct use of antalgics, especially opioids, from the early stages of disease onwards.