Canterbury DHB


Opioid Therapy for Severe Pain

Opioids may be required initially for severe pain or when milder analgesics have failed.

Morphine is the drug of choice – Panadeine/ codeine/ tramadol should be discontinued but paracetamol +/- NSAID should be continued.

Oxycodone, transdermal fentanyl, and methadone are alternative strong opioids that are available for use in palliative patients under specific circumstances. Further information on these drugs is found later in this section.

See the Opioid Conversion Guide.

The funding status of these opioid medications may alter and patients should be prescribed the one which is fully funded if possible. Check with a pharmacist if unsure.

The use of co-analgesics in this setting is strongly recommended as pain is often only partially opioid sensitive.

Note: Please read ALL of this section before prescribing.

In This Section

Anticipate and Warn Against Side Effects

Managing Opioid Toxicity

Opioids and Driving

Anticipate and Warn Against Side Effects

Managing Opioid Toxicity

Opioids and Driving

Taking opioids does not automatically mean patients cannot drive.

Ultimately the risk lies with the patient. If they are involved in an incident or are stopped by police, they will be questioned closely if they appear to be under the influence of drugs.

Recommended advice for patients

If your general alertness or concentration is reduced, or if you are physically weak or ill, it is UNWISE TO DRIVE.

If a doctor has indicated that driving is OK, always follow these general guidelines:

See NZTA Medical aspects of fitness to drive

About this Canterbury DHB document (4048):

Document Owner:

Kate Grundy (see Who's Who)

Issue Date:

March 2016

Next Review:

March 2018


Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 4048