BlessOTMA, I never considered that Alexei might have been on morphine, but you are right, it is possible. His parents may have truly conceded the idea that he never would lead Russia, and so perhaps morphine was less frightening. But if I had to guess, I think that the eyewitnesses who saw him in Tobolsk and Ekaterinburg may have been expecting a dazzling child, and so their shock at his waxen color was exaggerated...? If Botkin were giving him morphine, how would he have had a steady supply, which would be necessary in the long 1918 illness?
Alexei does look wan in the Rus photograph, and Olga depressed. No wonder. The emotional strain of wondering if/when your parents were going to face public humiliation and likely death must have been torture on those children, especially the 4 left behind.
Lack of appetite is a classic symptom of depression.