Administer drugs orally whenever possible. Avoid IM injections. Avoid using multiple opioids or non-opioids whenever possible. Avoid use of meperidine for chronic cancer pain management. Accumulation of toxic metabolite normeperidine can lead to CNS excitability and convulsions.
Addiction is psychologic dependence on an opioid for effects other than pain relief.
Addiction occurs rarely in patients receiving opioids for pain control. Physical dependence will develop with chronic opioid therapy. Taper dose to prevent withdrawal. Tolerance is a common physiologic result of chronic opioid use that may result in a larger dose of opioid needed to maintain the same level of analgesia. The patient is admitted to the hospital with uncontrolled pain and is to be started on a morphine drip until his nausea and vomiting is controlled.