Being in pain is a common fear of those with a terminal illness. Relieving pain and symptoms is a top priority with hospice care, so special attention is given to alleviate pain. Many myths are associated with the use of morphine. These misconceptions should not stand in the way of an individual receiving relief:
Myth: Morphine is a poor medication for pain or shortness of breath when taken by mouth.
Fact: Morphine taken by mouth is very effective when prescribed and taken appropriately. Experience has shown morphine therapy to be responsive or workable in many situations, reliable and safe. It is now recognized that when given in appropriate amounts, morphine taken by mouth is highly effective in relieving pain and shortness of breath.
Myth: Morphine lowers breathing function.
Fact: While respiratory depression (lowered breathing function) is the main possible hazard of all morphine preparations, medically important lowered respirations or breathing rarely occurs in patients with pain in whom initial doses of morphine are appropriately chosen and then increased. (We call this process of monitoring and increasing dosages “titrating,” which means to give to achieve an acceptable balance of pain control without unacceptable side effects.) Studies of patients with advanced malignancies or cancers showed no evidence that chronic breathing failure is either common or severe in those receiving high doses of morphine.
Myth: Morphine tolerance, or the body’s decreased response to the benefits of morphine, is an important problem in patients.
Fact: Tolerance usually does not develop rapidly when morphine is used for controlling cancer and other pain. Some increase occurs with time, but is usually relatively small, and is usually because of the disease worsening.
Myth: If morphine is prescribed too soon during the illness, nothing else is left.
Fact: As pain increases, the morphine dose can usually be adjusted upward to treat the increased pain. There is no maximum amount that can be given.
Myth: Morphine addiction is an important problem in patients with chronic illnesses.
Fact: Fears about psychological dependence (addiction) are often exaggerated when morphine is used to treat severe pain. The abuse of medications made from opium is rarely seen in patients with cancer or other severe pain, nor do these medications lead to addiction in terminally ill patients.
If you have questions about the use of morphine as a pain medication for your loved one, please contact a member of your hospice care team.