Respiratory depression secondary to morphine use in a patient with COPD and refractory breathlessness

Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction and progressive respiratory failure. Patients develop increasing breathlessness, which can persist despite optimal medical management (refractory chronic breathlessness) [1]. Various studies suggests that low-dose morphine may safely reduce refractory breathlessness in patients with advanced respiratory disease [2–6]; however, the recent population cohort study by Vozoris et al. [7] in the European Respiratory Journal suggests opioids may be associated with increased adverse respiratory outcomes, including death in older COPD patients. We report a case of respiratory depression secondary to opioid use for refractory breathlessness.