Question: What is the so-called “analgesic ladder” recommended by the World Health Organization?
Answer: According to the cited reference, the “so-called “analgesic ladder” is recommended by WHO to “meet the therapeutic challenges presented by opioid tolerance” and involves analgesic therapy “initiated with a non-opioid analgesic co-administered, if necessary, with an adjuvant. As the underlying condition progresses and pain becomes more intractable, a weak opioid is substituted for the non-opioid. Eventually a strong opioid is introduced as a final step.” (Dumas EO and Pollack GM. Opioid tolerance development: A pharmacokinetic/pharmacodynamics perspective. 2008 The AAPS Journal 10(4):537-551)