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WHO Analgesic Ladder licensed through http://www.ganfyd.org, a collaborative medical reference.
The World Health Organization (WHO) recommends a simple and effective three-step approach for treating pain based on its severity (mild, mild-to-moderate, or moderate-to-severe). The three step ladder has been used to provide effective pain relief for up to 90% of patients with cancer, but has broader applications.
If pain occurs, there should be prompt oral administration of drugs in the following order: non-opioids (aspirin and acetaminophen); then, as necessary, mild opioids (codeine); then strong opioids such as morphine, until the patient is free of pain. To calm fears and anxiety, additional drugs – "adjuvants" – should be used. To maintain freedom from pain, drugs should be given around the clock rather than as needed.
Climbing each step of the ladder sequentially is not necessary. Severe pain mandates the immediate use of opioids for moderate-to-severe pain without progressing sequentially from Step 1 to Step 3.
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