Do we use morphine often enough? An opinion survey in 100 rheumatology department patients

Shortly before their discharge from a rheumatology department, 100 patients with a mean age of 54 +/- 16 years completed a 20-item questionnaire on morphine therapy. Pain scale scores were 77.1 +/- 19 at admission and 44.2 +/- 24 at questionnaire completion.

Thirty-three patients, including 27 with spinal or nerve root disorders, received morphine during their stay. Five of these patients had a malignancy. Among patients who received morphine, 21% (6/29) were disappointed with the drug. Only four of the patients who did not receive morphine (4%) wished they had. Thirty-six percent of patients (30/83) reported previous morphine therapy given by a primary care physician (10/30) or a specialist (14/30) and/or in a hospital (22/30). Only five patients (5/100, 5%) said they regretted not having received morphine for past pain; however, 45% (35/78) of patients agreed with the suggestion that French physicians do not use morphine often enough. Most patients (82%, 65/77) agreed that morphine can be used to treat pain due to rheumatic disorders, although 92% (83/90) felt that morphine should be reserved for "intolerable" pain. Only 37% (34/92) of the patients were apprehensive about using morphine, 57% (45/79) were aware of the risk of dependency, 66% (44/79) of the risk of behavioral or attention disorders, and 53% (41/78) of the risk of tolerance.

Expectations of French rheumatology department patients about morphine use were roughly satisfactory. The mean pain scale score above which the patients felt morphine should be given was 70.5 +/- 20.