Opioid rotation: does it have a role?

occurs; the patient with prior exposure to opioids is less susceptible to significant opioid-initiation adverse effects. Incomplete cross-tolerance is evidenced in the patient who has a recurrence of the initiation side-effects of opioids after switching opioids. Subclinical or even clinical opioid withdrawal symptoms on switching from one opioid to another opioid also reflects incomplete cross-tolerance. At