As the pain mounts, so can the dose. Others fret that narcotics will cloud their minds or leave them completely sedated. One Washington, D.C., man, who did not wish his name to be used, saw his mother suffer horribly from abdominal cancer because she resisted taking the morphine prescribed by her oncologist. Yet in many cases, a skillful doctor can combine opioids with other drugs and analgesics to dull the pain without dulling the mind. It is usually at the very end that high doses are needed and the patient is kept sedated much of the time.
Doctors have their own concerns about prescribing narcotics.
In recent years, more physicians have become willing to employ narcotics at the end of life, though most are still not very skilled at doing so. But few doctors will even consider using the drugs to treat people who live in chronic pain, that is, pain that is not caused by cancer and lasts longer than a few months. A recent survey of 204 people with chronic pain found that most had sought help from an average of 10 physicians, yet only half had received drugs that reduced their agony. Chronic-pain patients who receive workers' compensation find the least compassion from healers. Suspecting them of being malingerers out for an easy buck, many hospitals and pain clinics turn such patients away at the door.