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Review

Opioid Use in Cancer Pain Management: Navigating the Line Between Relief and Addiction

by
Maite Trullols
and
Vicenç Ruiz de Porras
*
GRET and Toxicology Unit, Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2025, 26(15), 7459; https://doi.org/10.3390/ijms26157459
Submission received: 15 July 2025 / Revised: 30 July 2025 / Accepted: 31 July 2025 / Published: 1 August 2025
(This article belongs to the Special Issue Recent Progress of Opioid Research, 2nd Edition)

Abstract

The use of opioids for cancer-related pain is essential but poses significant challenges due to the risk of misuse and the development of opioid use disorder (OUD). This review takes a multidisciplinary perspective based on the current scientific literature to analyze the pharmacological mechanisms, classification, and therapeutic roles of opioids in oncology. Key risk factors for opioid misuse—including psychiatric comorbidities, prior substance use, and insufficient clinical monitoring—are discussed in conjunction with validated tools for pain assessment and international guidelines. The review emphasizes the importance of integrating toxicological, pharmacological, physiological, and public health perspectives to promote rational opioid use. Pharmacogenetic variability is explored as a determinant of treatment response and addiction risk, underscoring the value of personalized medicine. Evidence-based strategies such as early screening, psychosocial interventions, and the use of buprenorphine-naloxone are presented as effective measures for managing OUD in cancer patients. Ultimately, this work advocates for safe, patient-centered opioid prescribing practices that ensure effective pain relief without compromising safety or quality of life.
Keywords: opioids; cancer-related pain; opioid use disorder; pharmacogenetics; pain management; personalized medicine; addiction prevention opioids; cancer-related pain; opioid use disorder; pharmacogenetics; pain management; personalized medicine; addiction prevention

Share and Cite

MDPI and ACS Style

Trullols, M.; Ruiz de Porras, V. Opioid Use in Cancer Pain Management: Navigating the Line Between Relief and Addiction. Int. J. Mol. Sci. 2025, 26, 7459. https://doi.org/10.3390/ijms26157459

AMA Style

Trullols M, Ruiz de Porras V. Opioid Use in Cancer Pain Management: Navigating the Line Between Relief and Addiction. International Journal of Molecular Sciences. 2025; 26(15):7459. https://doi.org/10.3390/ijms26157459

Chicago/Turabian Style

Trullols, Maite, and Vicenç Ruiz de Porras. 2025. "Opioid Use in Cancer Pain Management: Navigating the Line Between Relief and Addiction" International Journal of Molecular Sciences 26, no. 15: 7459. https://doi.org/10.3390/ijms26157459

APA Style

Trullols, M., & Ruiz de Porras, V. (2025). Opioid Use in Cancer Pain Management: Navigating the Line Between Relief and Addiction. International Journal of Molecular Sciences, 26(15), 7459. https://doi.org/10.3390/ijms26157459

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