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What are the pharmacological characteristics of opioid drugs, which make them peculiar? What are the possible risks of substitutability? We talked about it with Prof. Diego Fornasari, whom we met in Riva del Garda on the occasion of the XXII National Congress of the Cultural Area Pain and Palliative Care (ACD) organized by the Italian Society of Anesthesia Analgesia, Resuscitation and Intensive Care (SIAARTI).