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

Patients and methods. Shortly before their discharge from a rheumatology de partment, 100 patients with a mean age of 54 +/- 16 years completed a 20-it em questionnaire on morphine therapy. Pain scale scores were 77.1 +/- 19 at admission and 44.2 +/- 24 at questionnaire completion. Results. Thirty-thr ee patients, including 27 with spinal or nerve root disorders, received mor phine during their stay. Five of these patients had a malignancy. Among pat ients who received morphine, 21% (6/29) were disappointed with the drug. On ly four of the patients who did not receive morphine (4%) wished they had. Thirty-six percent of patients (30/83) reported previous morphine therapy g iven 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 ag reed with the suggestion that French physicians do not use morphine often e nough. 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 s hould 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. Conclusion. Expectations of Fre nch rheumatology department patients about morphine use were roughly satisf actory. The mean pain scale score above which the patients felt morphine sh ould be given was 70.5 +/- 20. Joint Bone Spine 2000 ; 67 : 326-30. (C) 200 0 Editions scientifiques et medicales Elsevier SAS.