Did you know that some analgesics cause itching, and some treat it? Did you know that itch does not always originate in the skin? This session will discuss opioid-induced pruritus and the peripherally and centrally mediated mechanisms thought to be responsible. There will be an investigation into the impact of opioid type, dose, and route of administration on the incidence of pruritus. Proposed management strategies will be shared. Other common causes of nonhistamine mediated pruritus (ie, centrally mediated!) in patients with advanced illness receiving palliative or hospice care will be explored. Most importantly, attendees will learn when antihistamines are not the answer, and when gabapentinoids, topical anesthetics and counterirritants, antidepressants, and opioid antagonists might be! The next time someone suggests an antihistamine for pruritus, you may be inclined to reply “’Itch, please!”