Morphine or Fentanyl for Refractory Dyspnea in COPD

Exclusion Criteria

• •Other severe disease with chronic pain or chronic dyspnea (a non substantial component of left sided heart failure is acceptable).
• •Current use of opioids for whatever indication.
• •Allergy / intolerance for opioids
• •Psychiatric disease, not related to severe COPD.
• •Exacerbation of COPD 8 weeks prior to inclusion or between screening and randomization.
• •Problematic (leading to medical help or social problems) substance abuse during the last five years.
• •Active malignancy, with the exception of planocellular or basal cell carcinoma of the skin.
• •eGFR \<15 ml/min