Treating moderate to severe pain
Opioids are commonly used when pain is hard to ignore or feels very severe. These drugs need to be prescribed by a doctor. Opioids are not effective for all types of pain. For instance, moderate to severe nerve pain is treated with other types of medicine.
Learn more about:
- Opioids
- Working out the dose
- Opioids commonly used for moderate to severe pain
- Side effects of opioids
- Common questions about opioids
- Other medicines
Listen to our podcast on Managing Cancer Pain
Opioids
Opioids are medicines obtained from the opium poppy or created in a laboratory. They work on opioid receptors in the brain and spinal cord to reduce pain. There are many different types of opioids.
Codeine is often used for short periods to manage moderate pain. It is not recommended for long-term or palliative use because it causes constipation. In most cases, codeine is broken down in the body into morphine. However, one in ten people find they don’t get any pain relief as they cannot convert codeine into morphine.
Codeine is often available in combination with other pain medicines, such as paracetamol (e.g. Panadeine Forte) or ibuprofen (e.g Nurofen Plus). If taking one of these stronger combination pain medicines does not offer more relief, let your doctor know as you may need other opioids or a different type of analgesic.
Strong opioids, such as morphine, oxycodone, hydromorphone, methadone and fentanyl, are often effective for moderate to severe pain, and can be used safely if taken as prescribed. Commonly used opioids are listed below. They either release the opioid slowly to control your pain for long periods, or release it quickly to control pain for short periods.
Working out the dose
As people respond differently to opioids, the dose is worked out for each person based on their pain level. It’s common to start at a low dose and build up gradually until the pain is well controlled. Sometimes this can be done more quickly in hospital or under strict medical supervision.
Opioids commonly used for moderate to severe pain
Slow release (long-acting)
| Generic name | Brand name |
| fentanyl |
|
| hydromorphone |
|
| morphine |
|
| oxycodone |
|
| tramadol |
|
| tapentadol |
|
Immediate release (short-acting)
| Generic name | Brand name |
| morphine |
|
| oxycodone |
|
| hydromorphone |
|
| fentanyl |
|
| tramadol |
|
Click on the icon below to download a PDF booklet on Pain and Cancer.
Instructions for downloading and reading EPUB files
Apple devices
The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:
- email EPUB files to yourself and transfer the attachment to iBooks.
- copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
- open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.
Need more help? Visit: http://support.apple.com/kb/HT4059
Kobo
To download an EPUB file to your Kobo from a Windows computer:
- download and save the EPUB directly onto your desktop.
- connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
- select “Open folder to view files” to view the contents of your Kobo.
- navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.
To download an EPUB to your Kobo from a Mac:
- download and save the EPUB directly onto your desktop.
- connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
- open your “Finder” application.
- select “Kobo eReader” from the listed devices to view the contents of your Kobo.
- navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.
Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3
Sony Reader
To download an EPUB file on your Sony Reader™:
- ensure you have already installed the Reader™ Library for PC/Mac software
- select the eBook you want from our website and click the link to download it.
- connect the Reader™ to your computer.
- open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.
Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/
Amazon Kindle 2nd Generation devices
EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:
- download the PDF directly onto your computer.
- connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
- open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
- safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.
Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630
Android and PC
You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.
This information was last reviewed in September 2018
Support services
Coping with cancer?
Speak to a health professional or to someone who has been there, or find a support group or forum
Looking for transport, accommodation or home help?
Practical advice and support during and after treatment
Work and cancer
Information for employees, employers and workplaces dealing with cancer
Cancer information
Treatment side effects and nutrition
Learn how treatment affects nutrition, and more
Exercise during cancer treatment
Learn how exercise can benefit you both during and after cancer treatment
View our publications
Guides and fact sheets for people with cancer, their families and friends
