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Treatment aims to reduce symptoms, improve exercise capacity and quality of life, reduce exacerbations, slow disease progression and reduce mortality. However, breathlessness is common in patients with advanced <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> and remains undertreated. As all reversible causes of breathlessness are being optimally managed, consideration should be given to specific non\u2010pharmacological and pharmacological treatment strategies for breathlessness. Low dose morphine has been shown to reduce safely and effectively breathlessness in patients with severe <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> and refractory dyspnoea. However, despite numerous guidelines recommending opioids in this clinical setting, many barriers limit their uptake by clinicians. Integration of palliative care earlier in the disease course can help to improve symptom control for people with severe <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> and refractory breathlessness. A multidisciplinary approach involving both respiratory and palliative care teams offers a new model of care for these patients.<\/jats:p>","DOI":"10.1111\/imj.12857","type":"journal-article","created":{"date-parts":[[2015,9,2]],"date-time":"2015-09-02T19:08:50Z","timestamp":1441220930000},"page":"898-904","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Management of refractory breathlessness with morphine in patients with chronic obstructive pulmonary disease"],"prefix":"10.1111","volume":"45","author":[{"given":"N.","family":"Smallwood","sequence":"first","affiliation":[{"name":"Department of Respiratory and Sleep Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Palliative Care The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Currow","sequence":"additional","affiliation":[{"name":"Palliative and Supportive Services, Division of Medicine Flinders University  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Irving","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Philip","sequence":"additional","affiliation":[{"name":"Centre for Palliative Care St Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9]]},"reference":[{"key":"e_1_2_3_2_1","unstructured":"GOLD.Global initiative for chronic obstructive lung disease (GOLD). 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