This guideline covers safe and effective prescribing of strong opioids for pain relief in adults with advanced and progressive disease. It aims to clarify the clinical pathway for prescribing and help to improve pain management and patient safety. Care during the last 2 to 3 days of life is covered by care of dying adults in the last days of life. In August 2016, recommendation 1.1.12 was deleted and a link added to NICE’s guideline on controlled drugs: safe use and management, which has newer advice on the topic. Two out of date research recommendations have also been deleted.