Dose Guidance Revised: Oral morphine equivalent (OME)

The threshold for oral morphine equivalent (OME) has been reduced from 120mg to 90mg/day, with an ideal target of 50mg/day

The Faculty of Pain Medicine have reviewed and updated the Opioids Aware website resource. The resource has been updated reflecting the latest clinical evidence and international guidance. Opioids Aware is a living document with ongoing updates as new evidence arises and the key changes to the resource are highlighted below:

• The recommended oral morphine equivalent (OME) threshold has been reduced from 120mg to 90mg/day, with an ideal target of 50mg/day. These are more clearly designated as guidance and exceptions may be clinically appropriate.
• This change is based on new evidence highlighting increased harm at higher doses without proportional benefit.

Updated Literature, Reference and Terminology: All references and external links have been reviewed and updated and new information on safeguarding considerations when prescribing strong opioids, especially in vulnerable populations.

Updated patient information section: Updates to content, language, format and patient information leaflets.

The HWE ECF dashboard will continue to report on opioid items with a likely daily dose over 120mg oral morphine equivalence for 2025/6, with a line added to show the new threshold of 90mg.