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We (Sussex) have recently had a circular around which reads somehting like... Nubain is no longer available - we are looking into alternatives such as Tramadol JRCALC recommend that - Entonox is the alternative. para quote for the circular. When I questioned the role of Morphine with the training dept it fell on deaf ears as the excuses started mumbling through, such as "its on the drugs list but the local paramedical advisory group are not recommending it at this stage". I don't know much about medico legal aspects of this aspect of prescribing but it does seem to me that we are not offering patients standard care. Mike Bjarkoy