Initial nausea often resolves during the first few days, but the patient may need to use antiemetics. Severe vomiting may be caused by preservatives in the solution. Pharmacists can provide special formulations, but these require refrigeration. The dosage should be increased until pain is prevented without intolerable side effects. Double doses at bedtime may help the patient to sleep.
Constipation is inevitable with opiate therapy, so concurrent use of a laxative is essential.
Tolerance and physical dependence are not major problems when opiates are used appropriately in cancer therapy. Physicians should advise prospective travelers to avoid risk-taking behavior while visiting other countries. About 25 percent of all deaths of U.S. citizens who travel to other countries are caused by accidents. The leading causes of accidental deaths in tourists are motor vehicle crashes, drowning and homicide. The rate of traffic accidents in many developing countries is very high.