Inclusion Criteria:

- Ages Eligible for Study: 18 Years and older Genders Eligible for Study: Both
Accepts Healthy Volunteers: No

- Pathologic confirmed locally advanced or metastatic pancreatic cancer or biliary
tract cancer

- within 8 weeks after diagnosis

- cancer-related pain (Brief Pain Inventory [BPI] worst pain score >3), depression
(Center for Epidemiological Studies-Depression Scale [CES-D] >16) or both

- Karnofsky Performance Rating Scale ≥50%

Exclusion Criteria:

- Opioid intolerance

- History of drug or alcohol abuse

- Impaired sensory or cognitive function

- Pregnant or lactating woman

- Women of child bearing potential not using a contraceptive method

- Sexually active fertile men not using effective birth control during medication of
study drug and up to 6 months after completion of study drug if their partners are
women of child-bearing potential