Weighing the Evidence on Morphine

2012 March 31
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Scientific evidence can be misleading if it’s not put into the proper perspective.

A recent classic example: The fear generated when some animal studies showed that morphine may have adverse effects in people with cancer.

Board members from the International Association for Hospice and Palliative Care (IAHPC) weighed the evidence and gave it some context – please read:

In it, the authors Lukas Radbruch, MR Rajagopal (Pallium India chairman), Liliana De Lima, Eduardo Bruera, David Currow, Roberto Wenk, Jim Cleary, Carla Ripamonti and Michael I Bennett, members of the research and scientific committee of the IAHPC point out that recent studies linking opioids to cancer could be misunderstood:

“Two new studies and a commentary published in the April edition of the journal Anesthesiology report a link between opioid drugs used to relieve pain in postoperative and chronic cancer patients and cancer growth and spread.

A press release from the University of Chicago argues that this adds to the growing body of evidence that opioids can stimulate the growth and spread of cancer cells.”

The article concludes:

“The controversy on the published research data indicates that the effect of opioids on cancer growth and spread is rather small – a borderline effect.

The available evidence might also be used as a plea to use opioids regularly, not only for short periods of time, and in effective (high) dosages.

Even if future studies demonstrate that opioids promote cancer growth and spread, this negative effect is far outweighed by the positive effects of adequate relief of suffering.

Unalleviated pain, with its stress response and its adverse effects on energy, appetite and on general well-being would be a far more significant problem, and might also lead to significant comorbidity and shorter survival.”

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