Rapid Tolerance
Back to Misconceptions About Opioids
Correct! This is a myth. Opioids rarely cause rapid tolerance.
Tolerance is the need for increasing doses to achieve the same analgesic effect, and it is a form of tachyphylaxis. Clinically significant tolerance is unusual because the therapeutic range of opioids is very wide. After an effective baseline dose is established, requirements usually plateau until the disease progresses.
Because of concerns about tolerance, many physicians save the use of opioids for the very end of a patient's life. Patients also believe that if the pain gets worse they will have already taken the "best" medicine and thus have severe pain during the dying process.