[Opioids: modern concepts of pain management].

In cancer pain management the application of opioids is established and follows the WHO guidelines. In the management of chronic non-cancer pain opioids are used increasingly but the effectiveness is less. Several central and gastrointestinal side effects can limit the outcome. A careful patient selection is necessary and indications and contraindications must be regarded. The psychomotor performance is not impaired in all patients but must be controlled in the individual patient. In chronic pain management opioids are a component of an interdisciplinary concept and can be used safely by considering therapy rules and supervision.