Choice of opioids and the WHO Ladder

Physicians in developing countries who start to develop new, palliative care services face real barriers because of opiophobia in their countries. These physicians need to convince their colleagues in their own institutions about the need to adopt clear policies concerning pain management and palliative care in general. Moreover, these physicians need to explain the importance of such new services to their administrators and often legislators at the national level. People in the Middle East are facing cultural, traditional, and religious obstacles with regard to the introduction of opioids into regular use both in hospitals and in the community. In many countries, these drugs are believed to be drugs of addiction and in some cases, even dangerous drugs. Our goal is to enhance the establishment of pain units, being it within the framework of the Oncology Center, Palliative Care Services, or as stand-alone units.