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Safe and efficacious opioid rotation from high-dose morphine to BUP TDS has also been demonstrated in different types (musculo-skeletal, cancer, and neuropathic) of severe chronic pain.62 A final study assessed the efficacy and tolerability of an alternative transdermally applied opioid (either fentanyl or buprenorphine) in 32 patients with chronic cancer pain receiving insufficient analgesia using their present treatment. Large-scale, randomized clinical studies are needed to provide product comparisons on the use of analgesics in the treatment of neuropathic pain, although it was recognized that such studies may not be practicable. A retrospective study across 20 pain management centers assessed the effectiveness of BUP TDS (35 and 52.5 μg/h), over an 8-week period, in a total of 237 patients suffering from non-malignant neuropathic pain.52 Tramadol (75 to 110 mg/day) was provided for the treatment of breakthrough pain. 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