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Low-dose opioids should be considered for symptom relief also in advanced chronic obstructive pulmonary disease (COPD)
  1. Magnus Ekström1,2,
  2. Anna Bornefalk-Hermansson3,
  3. Amy Abernethy4,
  4. David Currow2
  1. 1Division of Respiratory Medicine & Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden
  2. 2Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
  3. 3Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala, Sweden
  4. 4Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
  1. Correspondence to Dr Magnus Ekström
    , Department of Medicine, Blekinge Hospital, Karlskrona SE-37185, Sweden; pmekstrom{at}

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We read with interest the comments by Dr Vozoris1 on our paper “Safety of benzodiazepines and opioids in very severe respiratory disease.”2 We are concerned that his comments might give the impression that opioids should not be used in patients with severe chronic obstructive pulmonary disease (COPD). This could contribute to symptomatic undertreatment and unnecessary suffering.

The main finding of the study should be emphasised: treatment with regular, low-dose opioids (≤30 mg oral morphine equivalents per day) was not associated with increased rates of …

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