Concerns about addiction

Physical dependence

Psychological dependence



Tolerance to a narcotic (opioid) means that a person needs more medication to feel the same pain relief. This is not a frequent problem in people with cancer taking narcotics. Much of the time, the need for a larger dose of medicine means that the cancer pain has grown worse, not that the patient is developing tolerance (or becoming "immune") to the medicine. More pain reliever is needed for more pain.

When people do develop tolerance, they usually report getting less relief from a dose of medicine, or that the dose feels effective for a shorter time. If that occurs, the dose and/or the timing of the medication need to be adjusted-it does not mean that the medication is going to stop working. When a person needs more of a narcotic to relieve pain (whether because of tolerance or because the pain has increased), there is no maximum dose of narcotics for cancer pain relief. Increasing the dose or taking a medicine more often because of increased tolerance does not mean someone is addicted to the medicine.

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