Patients with hepatic disease should use opioids:

Patients with hepatic disease should use opioids with caution due to the potential alterations in drug metabolism and elimination. The liver plays a crucial role in the biotransformation of many medications, including opioids. In individuals with hepatic impairment, the function of the liver can be compromised, leading to reduced metabolism and clearance of opioids. This can increase the risk of drug accumulation and associated side effects, including respiratory depression and increased sedation.

Thus, while opioids may still be necessary for pain management in these patients, it's essential that healthcare providers carefully assess liver function and consider dose adjustments or alternative medications to minimize risks. Using opioids without concern would not only be inappropriate but could also result in serious adverse effects. High doses would further complicate the situation by increasing the likelihood of toxicity. Moreover, prescribing opioids exclusively for patients with hepatic disease does not take into account the complexity of their condition and potential need for a multi-faceted approach to pain management.