Cancer pain is often undertreated in patients with cancer due to fears of iatrogenic addiction when opioids are used for pain control. Physicians and patients and their families fear that patients will use their medicines in aberrant fashion, become 'addicted' or use up their tolerance so that medicines will not be helpful to them when the disease advances and they 'really need the pain medicine'. Doctors and patients alike mislabel physiological dependence for addiction, misunderstand the phenomenon of tolerance, and are informed about the exceedingly low risk of addiction among medical patients. Z.S. 75 years old woman diagnosed inoperable cervix carcinoma, had been put on oral opioids due to severe pain. Our patient lived longer than expected and used oral opioids for three years, and applied to algology department when she was not able find any more opioids. No evidence of physical disease for a long time she used oral opioids only not to 'feel bad' longer than 2 years. We discussed important principles of opioid use in cancer pain and the difference between addiction and dependence. With the right indication, carefully planned pain control program patients could be treated by opioids with decreasing the risk of addiction and dependence to minimum
