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Opioid Crisis

Equianalgesia Dosing Considerations for Home Care Cancer Patients

Lee, Vanessa Y. BSN, RN; Kowalski, Sonya L. DNP, RN, ACNS-BC

doi: 10.1097/NHH.0000000000000825

As a result of the opioid epidemic, strategies have been implemented to reduce opioid consumption. These include regulatory policies, reduced opioid production, and nonopioid approaches for pain management. Although these policies may reduce opioid prescribing, there has been an unintended consequence for patients with severe cancer pain. Opioids are foundational for cancer pain management and are often required for patients during end-of-life care. Shortages of some opioid medications require knowledge of equianalgesic dosing. Equianalgesia is the conversion of comparable pain-relieving effects from one medication to another. There is a lack of consensus with regard to conversion standardization so researchers have created dosing principles that clinicians can follow. This article will describe some of these dosing principles and provide readers with sources for on-line dosage calculators.

Vanessa Y. Lee, BSN, RN, is a Staff Nurse, University Hospital, University of Michigan, Ann Arbor, Michigan.

Sonya L. Kowalski, DNP, RN, ACNS-BC, is an Associate Clinical Professor, McAuley School of Nursing, University of Detroit Mercy, Detroit, Michigan.

The authors declare no conflicts of interest.

Address for correspondence: Sonya Kowalski, DNP, RN, ACNS-BC, McAuley School of Nursing, University of Detroit Mercy, 4001 West McNichols Rd., Detroit, MI 48221 (

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