O10.1 Opioids

Opioids may have a role for patients with severe intractable dyspnoea. (Jennings et al., 2002) [evidence level I] Opioids have a small but statistically significant benefit in reducing dyspnoea [evidence level I]. In one study, the most significant adverse effect was constipation and there was no significant increase in respiratory depression, sedation or nausea and vomiting.(Abernethy et al., 2003) Nonetheless, opioids should be used with care in COPD. There is little evidence to support nebulised opioids in the treatment of breathlessness. (Jennings et al., 2002) The opioid dose required for symptom control should be established by titration, starting at a low dose and increasing until efficacy is achieved. There is little comprehensive evidence to guide clinicians on the use of opioids in COPD symptom control.