The World Health Organization pain ladder (WHO Pain Ladder) is used to determine the appropriate drug treatment in cases of nociceptive pain in cancer patients.
The pain ladder consists of the following three steps:
Step 1: non-opioids: for example, paracetamol, ibuprophen, voltaren
Step 2: weak opioids: for example, tramadol
Step 3: strong opioids: for example, morphine, oxycodon, fentanyl, methadon
Many people are reluctant to use opioids. It is true that opioids have side effects. Therefore, a drug to prevent constipation is always prescribed to be used in combination with opioids.
However, the fear of using opioids is very often based on prejudice or myths.
The drugs used to treat neuropathic pain in cancer patients are the same as those used to treat neuropathic pain in other patients.