Morphine, Fentanyl, Oxycodone, Hydromorphone… These words scare some people.


It is very common for controlled substances, like opioids, to be prescribed at end-of-life to assist with managing distressing symptoms.

Opioids can not only assist with pain and discomfort, but they can also assist with calming shortness of breath, however many people are hesitant to start taking narcotics, or give their loved one the narcotics, over fear of addiction, dependence, or unwanted side effects.

What is the difference between Addiction, Dependence, and Tolerance?


Addiction — compulsive drug use characterized by a continued craving for an opioid for effects other than pain relief.

Tolerance– the need for increasing or more frequent doses of an opioid to achieve the initial effects that were felt due to an adaptation to the medication.

Dependence– a state of the body where stopping the opioid abruptly results in withdrawal symptoms.

When a person is nearing end of life and experiencing discomfort, there are natural ways to alleviate the pain such as:

  • Use of intermittent heat or ice
  • Repositioning
  • Acupuncture or acupressure
  • Guided imagery
  • Meditation
  • Therapeutic touch or massage
  • Reiki
  • Distraction
  • Music therapy
  • Pet therapy
  • Non-narcotic medications.

Although these things can be helpful, many times an opioid will be prescribed by the physician to help control the pain or respiratory distress. This could be a controlled release medication, an immediate release medication, or both depending on the severity of the symptoms.

During this stage of life, it is highly unlikely that your loved one will become addicted to the medication if it is being taken as directed to control the symptoms.

The goal of the medication is to help the patient achieve peace and comfort and assist in alleviating distressing symptoms, not to cause addiction or hasten death.

If you would like to talk more about this, please feel free to reach out to me. I would love to help!