What is morphine?
Morphine is the principal derivative of opium, which is the juice in the unripe seed pods of the opium poppy, Papaver somniferum. It was first isolated from opium in 1803 by the German pharmacist Friedrich Wilhelm Sertürner, who named it after Morpheus, the god of dreams.
What is morphine used for?
Today morphine is used medicinally for severe pain, cough suppression, and sometimes before surgery. Given intravenously, it is still considered the most effective drug for the relief of pain. Taken as directed, morphine can be used to manage pain effectively. Many studies have shown that if properly managed by a physician, short-term medical use of opioid analgesic drugs can be safe.
Is morphine addictive?
Morphine is highly addictive. Tolerance (the need for higher and higher doses to maintain the same effect) and physical and psychological dependence develop quickly.
How is morphine taken?
Morphine is injected, taken orally or inhaled, or taken through rectal suppositories.
How does morphine affect the body?
Morphine, a narcotic, acts directly on the central nervous system. Morphine can;
- Relieve pain
- Impair mental and physical performance
- Relieve fear and anxiety
- Produce euphoria
It also can;
- Decrease hunger
- Inhibit the cough reflex
- Produce constipation
- Usually reduces the sex drive
- In women it may interfere with the menstrual cycle
What side affects can morphine have?
Morphine causes many side effects, including:
- Weakness and fatigue
- Feelings of elation (euphoria)
- Dry mouth
- Difficulty urinating
- Difficulty breathing
- Constipation, which may be severe
- Skin reactions, such as irritation, itching, or hives
- Taking a large single dose of an opioid could cause severe respiratory depression that can lead to death
What withdrawal symptoms does morphine have?
Withdrawal from morphine causes nausea, tearing, yawning, chills, and sweating lasting up to three days. Morphine crosses the placental barrier, and babies born to morphine-using mothers go through withdrawal.
What treatment options are available for morphine?
Several options are available for effectively treating prescription opioid addiction. These options are drawn from research regarding the treatment of heroin addiction, and include medications such as naltrexone, methadone, and buprenorphine, as well as behavioral therapies approaches.
Naltrexone is a medication that blocks the effects of opioid and is used to treat opioid overdose and addiction.
Methadone treatment has been used for more than 30 years to effectively and safely treat opioid addiction. Properly prescribed methadone is not intoxicating or sedating, and its effects do not interfere with ordinary activities such as driving a car. The medication is taken orally and it suppresses narcotic withdrawal for 24 to 36 hours. Patients are able to perceive pain and have emotional reactions. Most important, methadone relieves the craving associated with morphine addiction; craving is a major reason for relapse.
Methadone’s effects last four to six times as long as those of opiates, so people in treatment need to take it only once a day. Also, methadone is medically safe even when used continuously for 10 years or more. Combined with behavioral therapies or counseling and other supportive services, methadone enables patients to stop using morphine (and other opiates) and return to more stable and productive lives. Methadone dosages must be carefully monitored in patients who are receiving antiviral therapy for HIV infection, to avoid potential medication interactions.
Buprenorphine and other medications
Buprenorphine is a particularly attractive treatment for morphine addiction because, compared with other medications, such as methadone, it causes weaker opiate effects and is less likely to cause overdose problems. Buprenorphine also produces a lower level of physical dependence, so patients who discontinue the medication generally have fewer withdrawal symptoms than do those who stop taking methadone. Because of these advantages, buprenorphine may be appropriate for use in a wider variety of treatment settings than the currently available medications. Several other medications with potential for treating morphine overdose or addiction are currently under investigation by NIDA.
In addition to methadone and buprenorphine, other drugs aimed at reducing the severity of the withdrawal symptoms can be prescribed. Clonidine is of some benefit but its use is limited due to side effects of sedation and hypotension. Lofexidine, a centrally acting alpha-2 adrenergic agonist, was launched in 1992 specifically for symptomatic relief in patients undergoing opiate withdrawal. Naloxone and naltrexone are medications that also block the effects of morphine, heroin, and other opiates. As antagonists, they are especially useful as antidotes. Naltrexone has long-lasting effects, ranging from 1 to 3 days, depending on the dose. Naltrexone blocks the pleasurable effects of morphine and is useful in treating some highly motivated individuals. Naltrexone has also been found to be successful in preventing relapse by former opiate addicts released from prison on probation.
Although behavioral and pharmacologic treatments can be extremely useful when employed alone, science has taught us that integrating both types of treatments will ultimately be the most effective approach. There are many effective behavioral treatments available for morphine addiction. These can include residential and outpatient approaches. An important task is to match the best treatment approach to meet the particular needs of the patient. Moreover, several new behavioral therapies, such as contingency management therapy and cognitive-behavioral interventions, show particular promise as treatments for morphine addiction, especially when applied in concert with pharmacotherapy’s. Contingency management therapy uses a voucher-based system, where patients earn “points” based on negative drug tests, which they can exchange for items that encourage healthy living. Cognitive-behavioral interventions are designed to help modify the patient’s expectations and behaviors related to drug use, and to increase skills in coping with various life stressors. Both behavioral and pharmacological treatments help to restore a degree of normalcy to brain function and behavior, with increased employment rates and lower risk of HIV and other diseases and criminal behavior.
Detoxification programs aim to achieve safe and humane withdrawal from opiates by minimizing the severity of withdrawal symptoms and other medical complications. The primary objective of detoxification is to relieve withdrawal symptoms while patients adjust to a drug-free state. Not in itself a treatment for addiction, detoxification is a useful step only when it leads into long-term treatment that is either drug-free (residential or outpatient) or uses medications as part of the treatment. The best documented drug-free treatments are the therapeutic community residential programs lasting 3 to 6 months.
Opiate withdrawal is rarely fatal. It is characterized by acute withdrawal symptoms which peak 48 to 72 hours after the last opiate dose and disappear within 7 to 10 days, to be followed by a longer term abstinence syndrome of general malaise and opioid craving.