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  1. Jason Boland
  1. Consultant in Palliative Medicine, Barnsley Hospice, UK

https://doi.org/10.1136/bmjspcare-2011-000056

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    Once-daily opioids for chronic dyspnea: a dose increment and pharmacovigilance study

    1. Currow DC,
    2. McDonald C,
    3. Oaten S,
    4. Kenny B,
    5. Allcroft P,
    6. Frith P,
    7. Briffa M,
    8. Johnson MJ,
    9. Abernethy AP
    . Journal of Pain and Symptom Management 2010;11.021

    In a Phase II dose increment study and a long-term Phase IV effectiveness/safety study the effect of sustained-release oral morphine on dyspnoea was evaluated in 83 patients. Of those patients, 62% derived ≥10% benefit from morphine, in 70% this dose was 10mg/24h. One in three people continued to derive benefit at three months. Ranking of breathlessness was reduced significantly, but constipation increased despite laxatives. There were no episodes of respiratory depression or hospitalisations as a result of the morphine.

    Opioid dose and drug-related mortality in patients with nonmalignant pain

    1. Gomes T,
    2. Mamdani MM,
    3. Dhalla IA,
    4. Paterson JM,
    5. Juurlink DN
    . Arch Intern Med. 2011;171(7):691–693
    OpenUrlCrossRefPubMedWeb of Science

    A population-based nested case-control study of over 600 000 patients receiving opioids over a nearly 10-year period through the Ontario Provincial Drug Program. After adjustment for an array of clinical and demographic factors, it was found that average daily doses of 200 mg or more of morphine (or equivalent), …

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