The overall consumption of opioids globally and in Middle Eastern countries has been in the rise during the past 3 decades. However, whereas the consumption of opiates (morphine) increased by 19.8% that of the synthetic opioids (fentanyl) increased by 31.1% for the same time period. This trend increased even further during the period 2004-2008: morphine 16.6% vs. fentanyl 45.2%. One possible explanation to this phenomenon, especially in developing countries is the notion that many patients and their families still believe that morphine hastens death. The impressive rise in the consumption of fentanyl might be associated with the fact that this drug in contrast to morphine, might not be as directly related to "opioids" as morphine.