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Its early use was based on clinical experience alone until the identification of the opioid receptors and endogenous opioids 25 years ago. Advances in pharmacology and pharmacokinetics and the development of precision equipment to quantify the parent drugs and their metabolites in plasma have provided a better understanding of the mechanisms of action as well as adverse effects. Clinicians can now select the drug and route of administration to suit the patient's needs. The objective of care now is for clinical observation to be reinforced by randomized controlled trials and evidence\u2010based medicine, but controlled clinical trials are lacking for the use of opioids in chronic pain.<\/jats:p>","DOI":"10.1053\/eujp.2001.0275","type":"journal-article","created":{"date-parts":[[2002,9,19]],"date-time":"2002-09-19T13:56:27Z","timestamp":1032443787000},"page":"21-26","source":"Crossref","is-referenced-by-count":9,"title":["Evolution of a rational use of opioids in chronic pain"],"prefix":"10.1002","volume":"5","author":[{"given":"James P.","family":"O'Callaghan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,9]]},"reference":[{"key":"e_1_2_1_2_1","unstructured":"ACTS 1895\u20131908 Opium Act 1895 (SA) Aboriginals Protection and Restriction of the Sale of Opium Act 1897 (Qld) Opium Smoking Prohibition Act 1905 (Vic) Police Offences Amendment Act 1908 (NSW)."},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00262-D"},{"key":"e_1_2_1_4_1","unstructured":"Report of the Working Party on Management of Severe Pain1988."},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(79)90947-4"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/10401239209149570"},{"key":"e_1_2_1_7_1","first-page":"309","volume-title":"Opioids in Pain Control: Basic and Clinical Aspects","author":"Bruera E.","year":"1999"},{"key":"e_1_2_1_8_1","unstructured":"Drugs and Our Community March 1996: 131. 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