What it is: Analgesics are medications used to relieve the symptom of pain. Opioids are analgesics. They are often used for pain and dyspnoea in terminal illness.
Morphine is an opioid analgesic that offers safe and effective relief of moderate to severe pain. There are others. Opioid induced constipation requiring use of laxatives is a common side effect.
Why it matters: Opioids can be administered to reduce or minimise pain via various routes including: oral, transdermal, injection, and subcutaneous infusion. The route chosen will depend on the individual. Nurses have an important role because they often administer medications. Nurse Practitioners may also prescribe medications.
What I need to know: Response to opioids including the dose required or tolerated depends on the individual. Older people and their family may need to be reassured as there are many myths about opioids. Nursing staff can provide older people and their families with information to reassure them.
Wrong information may affect:
- willingness to accept morphine for pain
- understanding of why morphine is needed
- a nurse’s readiness to administer morphine.
Appropriateness of opioids needs to be taken into consideration in the case of:
- liver or kidney disease
- an allergy to opioids
- pain that is difficult to control.
‘Opioid switching’ is the practice of switching to another opioid if pain persists or the person experiences adverse effects. This requires frequent review and assessment for pain and adverse effects.
Breakthrough pain should be treated with a relevant immediate-release opioid. Individual opioids may interact with other medications and this should always be assessed.
Be aware that ‘spiritual pain’ is different to physical pain.