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According to the World Health Organization cancer pain relief guidelines, opioid analgesics are the mainstay analgesic therapy in addition to conventional first\u2010step analgesics, such as non\u2010steroidal anti\u2010inflammatory drugs and acetaminophen. The indications for strong opioids have recently been expanded to include mild\u2010to\u2010moderate pain in addition to moderate\u2010to\u2010severe pain. The U.S. Centers for Disease Control and Prevention guidelines emphasize that realistic expectations should be weighed against potential serious harm from opioids, rather than relying on the unrealized long\u2010term benefits of these drugs. Therefore, treatment strategies for both cancer\u2010related chronic or acute pain have been unfortunately deviated from opioid analgesics. The barriers hindering adequate cancer\u2010related pain management with opioid analgesics are related to the inadequate knowledge of opioid analgesics (e.g., effective dose, adverse effects, and likelihood of addiction or tolerance). To achieve adequate opioid availability, these barriers should be overcome in a clinically suitable manner. Genetic assessments could play an important role in overcoming challenges in opioid management. To balance the improvement in opioid availability and the prevention of opioid misuse and addiction, the following two considerations concerning opioids and genetic polymorphisms warrant attention: (A) pain severity, opioid sensitivity, and opioid tolerance; and (B) vulnerability to opioid dependence and addiction.<\/jats:p>","DOI":"10.1002\/jnr.24756","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T07:11:44Z","timestamp":1605078704000},"page":"362-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Genetic implications in quality palliative care and preventing opioid crisis in cancer\u2010related pain management"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3662-8217","authenticated-orcid":false,"given":"Masahiko","family":"Sumitani","sequence":"first","affiliation":[{"name":"Department of Pain and Palliative Medicine The University 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