A common concern with hospice care is the use of morphine and some myths regarding its use. In our last post we discussed an overview of these concerns and why hospice uses morphine. This week we’d like to address the most common objections to its use and some of the myths surrounding that.
“But morphine is for drug addicts.”
While it is true that there is a growing health crisis involving opiates, the sort of Morphine administered in a hospice setting is quite different from the drugs at the center of the opioid addiction crisis. The type of opioids involved in the current health crisis are usually prescription pills unlike the vials, syringes and patches used in hospice.
Morphine use in a hospice setting also consists of much lower, managed doses administered by a trained healthcare professional. An essential part of addiction is the drug-seeking behavior. Hospice patients generally do not exhibit this behavior. When their pain is managed, they don’t go after more opiates. It’s also a good idea to keep a log near the medicine to track the timing, volume and effectiveness of each dose.
“Morphine will make my loved one sleepy and they won’t be themselves.”
Allowing a patient and their family time to share together is one of the primary goals of hospice. Morphine is only given to manage pain and symptoms, not as a means to sedate the patient or make them “high” so that they are not themselves. Morphine, especially in low doses, helps with the patient’s symptoms so that they may be more of themselves than a product of their ailments. It does not affect them mentally or change their personality.
Just as with any medication, when first starting the patient may take some time to adjust. This may include initial drowsiness but after the first few days, these effects go away. Every person is different however, and some may react in different ways to opioids. In these cases it is up to the patient, their family and their care team to consider alternate forms of pain management.
There is no evidence that opioids speed up the process when a person is already terminally ill as long as they receive the proper dose to control their symptoms. The opposite may actually be true. Troubled breathing and constant pain drain hospice patients of their energy and strength. When these symptoms are relieved, the patient can be made more comfortable and even slow down the rate of decline.
This myth stems from the circumstances in which morphine is used. If a patient is in hospice and prescribed morphine, they are usually in the advanced stages of terminal illness. The person is in the process of transitioning with or without the morphine. Sometimes the patient’s final moments may come shortly after a dose of medication, but this is just a coincidence.
Hospice seeks to provide a comfortable passage through the end of one’s life. Hospice never intends to speed up this passage, only to make it more peaceful. Morphine is nothing more than a tool to aid in this goal.