ABSTRACT
This chapter presents a case study of Pat, who is a 36-year-old woman, married, with two sons aged 12 and 9 years. She had problems with her bowels for several months before some rectal bleeding made her see her general practitioner. She has been on oral morphine for several months, but is asking if it can be given in any other way. A potent opioid will need less drug to give the same pain relief as higher doses of a weak opioid. Pat needs an opioid by a non-oral route that is at least as potent. There are several opioids: morphine, diamorphine, buprenorphine and fentanyl. It is possible to have a potent drug such as buprenorphine which is 60 times more potent than oral morphine, but less effective at high doses. So, Pat's pain would not be better relieved by changing to a more potent opioid or route.
