Acupuncture an Alternative to Morphine for Breathlessness

Acupuncture as Effective as Morphine for Breathing Difficulty 

Background: Breathing difficulty is common in those with lung disease and lung cancer.  Both opioids (morphine like medications) and acupuncture can relieve breathlessness.

Study: Dr. Anna Minchom and colleagues at the Royal Marsden Hospital in the United Kingdom performed a study in 173 individuals with lung cancer. The study was published on-line in the European Journal of Cancer (May 6, 2016). All subjects reported breathing difficulty of at least a score of 4 on a visual analog scale (a 10 cm line anchored at one end by “no shortness of breath” and at the other end by “worst shortness of breath”). The person marks the line when instructed to indicate her/his shortness of breath at the time.

There were three treatment groups. Subjects received one of the following:♦ morphine alone (when requested because of shortness of breath) ♦ acupuncture alone [sites were upper front of chest (sternal), in the back on either side of the spine (paravertebral), trigger points in the muscle that attaches to the scapula, and LI 4  ♦ both morphine and acupuncture.

Acupuncture site LI 4 located between thumb and 2nd finger,

Site LI 4 where needle was placed between thumb and 2nd finger,

 

The primary end-point was the proportion of subjects who reported an improvement of at least 1.5 points on the visual analog scale at 4 hrs after receiving treatment.

Results: Shortness of breath improved in 60% with morphine, 74% with acupuncture, and 66% with the combination. Analysis showed no statistical difference among the three treatments. 

Conclusion: The investigators concluded that both morphine and acupuncture were effective in relieving breathing difficulty. Acupuncture is an alterntive to morphine for relief of shortness of breath in those with lung cancer.

My Comments: This study provides additional support for the use of acupuncture for relief of breathing difficulty. In this study acupuncture also relieved anxiety and spared use of morphine. See my post on January 28, 2016, under COPD News for additional information on how acupuncture can help with breathlessness. If you decide to try this treatment for your breathing difficulty, make sure to find an acupuncturist who has knowledge and experience with the appropriate sites to relieve shortness of breath. 

 

 

 

 

Narcotics for Distressful Breathing

A Review of Different Studies

Ekstrom and colleagues reviewed the effects of narcotics on relief of distressful breathing and exercise ability in the March 24, 2015, issue of the Annals of the American Thoracic Society.

Based on the results of 8 studies involving those with COPD, narcotic medications (usually morphine) given as a pill or by a shot (injection) reduced the severity of breathing difficulty. The benefit of narcotic medications given as a solution in a nebulizer was considered to be “low.” Narcotic medications had no effect on the exercise ability of the patients with COPD (13 studies).

Comment: Narcotic medications are used routinely for reducing pain. This review confirms that narcotic medications, mainly morphine, are effectively for reducing breathing difficulty. Usually, narcotics are used when breathing difficulty becomes persistent and distressful despite use of the best available treatment for COPD. This includes inhaled bronchodilators, possible use of an inhaled corticosteroid, oxygen if indicated, and pulmonary rehabilitation if appropriate.

Before a trial of morphine, your doctor should discuss the goals of using morphine as well as possible side effects of the medication. Side effects may include drowsiness, sleepiness, nausea, upset stomach, and constipation.