Janowiak P, et al. - This double-blind, controlled, cross-over trial was carried out to compare any clinical or statistical differences in breathlessness intensity between nebulized 2.0% morphine and 0,9% NaCl in patients with very severe chronic obstructive pulmonary disease (COPD). According to findings, dosimetrically administered nebulized morphine was superior in attenuating breathlessness, as compared with NaCl. The mechanism involved may be morphine’s direct action on receptors in large airways, although a systemic effect from absorption via the lungs cannot be excluded.