A 59-year-old with obesity has symptomatic knee osteoarthritis. Therapeutic exercise, weight-management support and a topical NSAID have provided inco...

Question

A 59-year-old with obesity has symptomatic knee osteoarthritis. Therapeutic exercise, weight-management support and a topical NSAID have provided incomplete relief. Oral NSAIDs are contraindicated because of chronic kidney disease. They ask to start a regular opioid for long-term pain control. Which statement best reflects current UK prescribing guidance?

Accepted Answer

Avoid strong opioids; use a weak opioid only infrequently and short term if other drug options are unsuitable or ineffective

Answer

Start modified-release morphine because continuous pain is best treated with continuous opioid exposure

Answer

Start regular codeine and add a benzodiazepine if opioid-related sleep disturbance develops

Answer

Start tramadol and increase the dose whenever analgesic tolerance reduces its clinical effect

Answer

Select and review opioid treatment mainly against fixed oral morphine-equivalent dose thresholds

Chronic Pain Opioid Prescribing — PSA MCQ