Chronic Low-Dose Morphine to Improve Breathlessness in Patients with COPD?

Data on chronic opioids for breathlessness in patients with chronic obstructive pulmonary disease (COPD) are conflicting, and concern has been raised about possible respiratory depression. Dutch researchers examined low-dose morphine in 111 COPD patients with moderate-to-very severe chronic breathlessness (modified Medical Research Council [mMRC] breathlessness scale grade, 2–4) who were randomized to sustained-release morphine (10 mg twice daily) or placebo for 4 weeks.

Morphine recipients exhibited a statistically significant mean 2.2-point improvement (baseline mean score, 22) on the COPD Assessment Test (CAT), which is a 40-point disease-specific health status questionnaire. Arterial partial pressure of carbon dioxide (PaCO₂) values were…