Case Report: Managing opioids in palliative care

A stoic, elderly patient is assisted to live as comfortably as possible, with minimal pain.

Susan is aged 78 and a relatively new patient. She has carcinoma of the lung, with bone metastases in her thoracic spine and several of her ribs. Most of her pain appears to be coming from the metastases in her ribs.

You assessed Susan four weeks ago and prescribed regular paracetamol and immediate-release morphine mixture (Ordine) 2mg/mL, 2-3mL one-hourly prn.

She did not admit to having much pain and you suggested that although it was possible to take