notes from palliative care book, regarding the narcotics... in the absence of heroin, morphine remains the gold standard for pain relief in terminal illness. Codeine is useless and is a bad drug. Oxycodone is very problematic and far less than effective in pain control than morphine in the terminal phase. Hydromorphone is ok, but you should add some methadone to make it more comprehensive. Fentanyl is ok if you like to see happy hairless rabbits in your room...but as time goes by, the rabbits can change into really awful things. Stick with morphine. First choice. Add some midazolam, a tad of haloperidol, a concomitant subset load of methadone for the bones, and you'll be right as rain. If you need far more than 600mg morphine subcut a day, with the additions of methadone, midaz, and haloperidol, then you may need to flush the body IV for a day and start again as the morphine metabolites, in a dying body, tend to eat each other when the concentrations get too much. have a day off, flush the body IV, then come back next day with 300mg morphine, subcut, 5 haloperidol, 30 midaz, 40 methadone...and then titrate up to the need. You can still be sitting in bed doing your crosswords, but you just won't be in massive pain. the human condition...Its not rocket science. if you haven't got good pain control within 3 days, then the people caring for you really don't care, or don't know what they are doing. You could need up to a gram of morphine a day, plus the other stuff, but usually only if you have let the oncologists and surgeons have done too much harm to your receptors by pointless, heroic (for you) and simply cruel interventions.