REGUERAS ESCUDERO, E    LOPEZ GUZMAN, J. Ethical discussion about the growing use of opioids in Spain: is it fundamented the limination of inmediate release fentanyl use?. []. , 33, 1, pp.83-89.   27--2023. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x2023000100015.

The current environment of addiction and mortality associated to both illegal and prescription opioids in United States of America (what is commonly called the opioids epidemic) has put on the table the ethical discussion about the use or not of opioids in off-label, especially in relation to the use of immediate release fentanyl in non-cancer patients. In 2018 the Spanish Agency of Medicines issued a warning note about the use of those medicaments supporting this decision in some arguments and data that will be analyzed in this publication. Those drugs have an essential role in the treatment of breakthrough pain, that is present in both cancer and noncancer patients. Considering the warning of the agency, doctors are facing the ethical dilemma of no use these drugs in no-cancer patients or prescribe them as off-label.

: Opioids; pain; breakthrough; fentanyl.

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