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“STARTING opioids is not a trivial decision, and opioids should not be commenced unless the doctor knows the patient and understands their psychosocial situation.” This advice from Therapeutic Guidelines: Analgesic, about the treatment of chronic pain, is supported by the recently published results of a Canadian study. This study found that the GPs of patients who died from opioid-related causes were likely to be high prescribers of opioids. In the US, opioid-related deaths now exceed those from HIV.1 The rise in these deaths reflects the increasing use of opioids for chronic pain despite limited evidence for their ...