Opioid Use in the Philippines - 20 years after the introduction of the WHO analgesic ladder

There was adequate knowledge about the WHO analgesic ladder among the respondents. There is a perceived resistance to prescribe strong opioids like morphine making the step 2 of the ladder as a comfort zone by the physicians who tend to “overstay” in this step. Government regulatory policies have affected the physicians' attitudes concerning narcotics license application. There is a very slow, though steady increase in morphine and oxycodone usage in the country. Barriers to opioid use in cancer pain management still persist twenty years after the introduction of the WHO analgesic ladder.