Hi, Thanks for writing in. Sorry to know about your close friend. Unfortunately stage 4 cancer is a difficult condition to treat and you might be aware of his condition. Pain relief is an important area of concern and I agree that your friend should be spending the time he has in peace and comfort. Opioids are a good form of pain relief and are recommended at variable doses. It is possible that there is significant destruction of the lower spine and this is causing a lot of pressure on the nerve roots. Alternative pain relief measures like accupuncture, steroid injection and nerve blocks are available and he might benefit from these techniques. He can keep narcotics to take at the time of severe pain when required. Please consult a pain relief specialist and discuss the alternative pain relief treatments and techniques which are available at his place. Please do not worry.