When working to control pain in the terminally ill patients, five principles are important to remember:

1. Pain is the "disease"
2. Believe the patient
3. Complete a thorough history and physical exam
4. Elevate the pain threshold
5. use pharmacological management of chronic pain

Nine Principles of Narcotic Use for Chronic Pain

When using narcotics to control pain, nine principles are important to remember: 

1. Use agnostic as first line therapy
2. Do not stay with weak narcotics if pain persists
3. Use oral route whenever possible
4. Use round the clock dosing
5. never administer narcotics on a p.r.n. basis
6. Titrate dose individually
7. Use adjuvant medications
8. Use narcotics as one part of total pain control
9. Follow the World Health Organization Pain Ladder