While the origins of pain have been widely debated throughout time, even in its most primitive forms, the relief of pain has relied largely on medicinal plants to manage severe injuries and persistent pain.1

One of the earliest known natural pain relievers, opium, has been traced to the ancient civilisations of the Mesopotamians, Egyptians, Greeks and Romans, being used routinely from as early as 3000 BC.1

An increased understanding of the medicinal properties of opium and the introduction of a tincture of morphine in the 16th Century heralded a significant change in the development of opioids and their application. This most commonly used strong opioid tincture was formed using alcohol to extract opium, and its use quickly spread. However, while the medicinal benefits of opioids are widely accepted, fears of misuse have led to a long and often contentious history coloured by events such as the First Opium War of 1841.2

The introduction of morphine, followed by other synthetic opioids such as oxycodone, fentanyl, methadone and hydromorphone, heralded a new era in pain management.

Under the guidance of a physician and healthcare team, modern opioid preparations provide well tolerated and effective pain management. Opioids are endorsed by the World Health Organization for the management of those suffering from pain.3

The use of opioids should form part of a coordinated pain management strategy. It must be emphasised that uni-modal treatment with drugs alone is often unsuccessful when managing patients with complex pain.

A reflection of the fundamental right of patients to have their pain managed, research has shown that following opioid therapy, almost one in two patients who had previously requested physician-assisted suicide due to their pain and overall poor quality of life, changed their minds.4

1) History of pain – Available from: URL: http://opioids.com/pain-management/history.html.
2) A History of Opium – Available from: URL: www.opioids.com/timeline/index.html.
3) World Health Organization. Cancer pain relief with a guide to opioid availability. 2nd ed. Geneva: The Organization;1996.
4) Ganzini, et al. Physicians’ Experience with PAS in Oregon. NEJM 2000.


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