Table 2 Myths and barriers to prescribing morphine

Professional fears about safety of morphine and addiction

Logistic supply chain and transport inadequacies

Public fears that morphine expedites death

Lack of pharmacists and pharmacy support

Perceived difficulties in predicting national requirements

Lack of trained palliative care staff

Fears about illegal diversion

Over regulation, legal barriers and complex regulations

Fear of inaccurate diagnosis

Difficulties finding patients in need of care and following them up

Perception that all therapeutic morphine prescribed needs to be accounted for

Lack of hospital/palliative care vehicles

Low priority given by medical staff to the dying

Palliative care nurse training lengthy

Cost of complimentary drugs e.g. laxatives or Step 1 and 2 analgesics

Perceptions that laws governing therapeutic morphine are difficult to change

Morphine storage difficulties

Health staff overwhelmed

Low priority by hospitals to palliative care