Hi, this is Dr. Jeff Gudin, I am a pain and palliative care specialist at the Englewood Hospital and Medical Center in Englewood, New Jersey. I am often asked to discuss the adverse effects seen with opioid analgesics, and most of you already are familiar with the common AEs seen with this class of agents. We know constipation is probably the most common and bothersome, but there are also others such as itching, sweating, nausea, vomiting, dizziness, somnolence. Most patients will become tolerant to the adverse effects of opioids, especially if we titrate the agent slowly. Unfortunately one of the most bothersome side effects, constipation, or what has now become known as OIC, opioid-induced constipation, patients do not develop tolerance to this when it comes to opioids, and this OIC usually requires treatment over time. So whereas a patient who may develop nausea or dizziness or sedation, if they stay on the opioids, those adverse effects usually get better over time, the patient gets tolerant to those adverse effects. Unfortunately for patients, we have not seen the development of tolerance when it comes to opioid-induced constipation. This is the reason we need to assess constipation in our patients and treat it aggressively. Thank you so much.