The debate on the legalization of heroin has focussed attention on the broader issue of pain management of cancer. Clinicians in palliative care should be aware that poor pain management is related primarily to lack of knowledge, appropriate skills and attitudes, and health care resources. The availability of heroin will not improve these. The need is for research about pain and alternative drugs and dosage forms and the variables affecting efficacy. Professional and public education about pain management is essential.
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