This certainly would seem to be a very worthwhile service to the community, yet there is hesitancy on the part of physicians, patients and families to be accepting of hospice. It has only been since becoming part of hospice that I actually learned the nature and importance of adequate pain and symptom control. Morphine and related narcotics are the gold standard of pain management. They may be prescribed safely in dosages many times the amount usually given for trauma or post-operatively. Addiction is never a problem and tolerance is not a factor if narcotics are prescribed properly.
Patients often are able to function relatively normally on massive doses of narcotics.
Fentanyl, a powerful synthetic narcotic may be administered by a subcutaneous patch which lasts for up to 3 days. This product is soon to be available in a sucker-like product which will allow rapid absorption when placed adjacent to the oral mucosa and act similarly to intravenous morphine. Radiation therapy is often specific for cancer involving bone. New methods are being utilized which involve giving large amounts of radiation over a short period of time rather than the usual series over several weeks. Nerve blocks and operative procedures with the assistance of anesthesiologists and surgeons are utilized in specific, difficult cases.