1. Myths surrounding the use of opioids
• Morphine is offered to patients only when death is imminent
• Pain medications always lead to addiction
• People on morphine die sooner because of respiratory depression
• Pain medications always cause heavy sedation
• People should not take morphine before their pain is severe as it
might lose its effect.
• Some kinds of pain cannot be relieved.
• Effective pain management can be achieved on as needed basis
• Opioid analgesics should be avoided in older patients.
2. Fear surrounding the use of morphine
• Psychological dependent or addiction
Health workers give limited doses of morphine because of fear of
addiction
Studies in India and Africa have shown no record of addiction in patients
who use morphine for the control of pain.
Physical dependence
This is a normal physiological response to chronic opioid therapy which
causes withdrawal symptoms if the medicine is suddenly stopped. If the
pain has been relieved withdrawal of morphine should be done slowly.
3. Tolerance
The need for an increased dose of morphine does not mean that the
patient is becoming tolerant but it is the disease process that becomes
worse causing more pain thus the need for more pain medication
Myths explain
• It is not the stage of life threatening illness but the degree of pain that
dictates which medicine to use.
• Patients usually start on morphine when it is appropriate, some
people never need morphine, while others will require it for quite a
while.
• Respiratory depression is very uncommon except in opioid-naïve
patients commenced on intravenous morphine.
• Respiratory depression will not occur if morphine is given orally in a
low starting dose and started carefully.
4. Non-pharmacological methods of pain control
• Music therapy
• Herbs
• Radiotherapy
• Surgery
• Chemotherapy
• Heat or cold compress
• Communication
• Massage
