### Pain Opioids reduce pain transmission and the distress associated with pain. They do not treat every cause of discomfort, so combine them with positioning, wound care, heat or cold when appropriate, treatment of constipation, and management of anxiety or muscle spasm. Scheduled analgesia is useful when pain is continuous; as-needed medication is added for flares. If rescue medication is repeatedly needed, reassess the pain pattern and underlying cause rather than simply repeating doses indefinitely. The prescriber or palliative team may need to revise the scheduled regimen, opioid, route, or treatment of the underlying problem. Tolerance can occur as illness and opioid exposure continue; tolerance is not the same as addiction. Addiction involves impaired control, compulsive use, and continued use despite harm. Fear of addiction should not lead to withholding an opioid prescribed to relieve serious-illness pain. ### Breathlessness Air hunger can be frightening even when oxygen saturation is not markedly reduced. Sit the patient upright, reduce unnecessary exertion, provide calm coaching, improve airflow with a fan if acceptable, and use oxygen when hypoxaemia or subjective benefit supports it. A...