What is Morphine?
Morphine is used for severe pain. It may be taken alone or with other pain medicines such as acetaminophen or ibuprofen. This medicine should not be combined with alcohol. Keep this medication out of the reach of children and away from excess heat and moisture. Ask a pharmacist about a drug take-back program.
History
Morphine is a powerful opioid that is used as an analgesic to treat pain in patients. It is also used recreationally for its euphoric effects and can cause physical dependence that leads to addiction. The drug is derived from the seedpod extract or opium that is produced by the Papaver somniferum plant. It is often combined with other substances to enhance its psychoactive and painkilling properties.
In the early 19th century, morphine was a very popular drug among soldiers who fought in the American Civil War. The war was so bloody that it has been described as the most deadliest in history, but a new drug helped many soldiers cope with the pain of their wounds and even helped them sleep at night. Drug historian David Courtwright explains that many soldiers became addicted to morphine and stayed hooked after the war ended.
A pharmacy’s assistant named Friedrich Wilhelm Serturner worked in his spare time to isolate a yellowish-white crystalline substance from crude opium by immersing it in ammoniated hot water. He experimented with smaller doses and found that the compound reduced pain, caused a feeling of euphoria, and suppressed cough. He hailed his discovery as ten times more potent than opium and called it ‘morphium’ after the Greek god of dreams and sleep, Morpheus. In 1821, he introduced it commercially.
Medications containing morphine are still widely used in the treatment of serious chronic and acute pain. It is important to remember that repeated use can lead to tolerance, meaning that a larger dose of the medication will be needed to achieve the same effect. Tolerance can also cause individuals to become dependent on the drug and develop withdrawal symptoms when they stop taking it.
The medication acts by binding and activating the m-opioid receptors in the central nervous system and gastrointestinal tract. Its main pharmacological actions are analgesia and sedation, although it can also cause nausea, vomiting, constipation, and respiratory depression. Morphine can also interact with other drugs, such as antidepressants, benzodiazepines, and barbiturates.
Side effects can include dizziness, drowsiness, weakness, vomiting, constipation, stomach upset, and mental changes (including confusion). If you have any of these side effects, call your doctor or pharmacist right away.
Symptoms
Morphine may cause serious, life-threatening breathing problems if used in high doses or for long periods of time. It is important to use this medicine only as directed by your doctor. Do not take more of it or use it more often than prescribed by your doctor. Your doctor may direct you to also take other pain relievers (such as acetaminophen, ibuprofen) with this medication. Ask your doctor how to give the other pain medications and the correct way to take them.
You may get drowsy or dizzy when you first start taking this medication. Do not drive, operate machinery, or do any other activity that requires mental alertness until you know how this medication affects you. Elderly patients may be at a greater risk for dizziness and fainting. Alcohol can interfere with the effects of this medication. If you drink alcohol, talk to your doctor about how much is safe for you.
Symptoms of overdose may include difficulty breathing, unconsciousness, and slow heart rate. If you think you have overdosed, seek emergency medical help immediately. Overdose symptoms may also include vomiting, slurred speech, uncontrollable shaking of a part of the body, and seizures. Some people may have no symptoms when they overdose on morphine.
It is important to tell your doctor if you have ever had any type of breathing problem, such as asthma; liver disease; or kidney disease. Your doctor will also want to know if you have any other health problems, such as a history of drug or alcohol addiction, depression, mental illness, stomach/intestinal/digestive problems, or if you smoke.
This medication can be habit-forming. To prevent addiction, you must not stop using this medication suddenly. If you have used this medication regularly for a long time or in high doses, you may experience withdrawal when you stop. Withdrawal symptoms may include restlessness, watery eyes, runny nose, nausea, diarrhea, sweating, muscle aches, or changes in your mood or behavior. To avoid withdrawal, your doctor may lower your dose slowly. Withdrawal may also lead to life-threatening breathing problems if you have used narcotics for a long time or in high doses.
Treatment
Morphine is used to treat moderate to severe pain. It works in the brain to change how the body feels and responds to pain. It is also used to relieve symptoms of certain cancers. This medication may cause drowsiness, dizziness or lightheadedness. These effects may be more likely if you take it with other medications that slow your breathing or make you sleepy, such as sedatives, muscle relaxants and antidepressants. Do not drink alcohol or take other drugs that can affect your breathing while taking morphine. Follow your doctor’s instructions for how to take this medication. Morphine comes as a solution (liquid) to take by mouth, an extended-release tablet to take by mouth (such as MS Contin and Arymo ER), and an extended-release capsule to take in the stomach (such as Kadian). It is usually taken every 4 hours or as needed for pain. Your doctor will adjust your dose if needed.
Morphine can be mixed with other medications or given by a special injection into the body (subcutaneous) under the skin, the thigh, or top of the arm. It is often given with other pain medicines, such as acetaminophen and ibuprofen. Morphine may interact with naloxone, an opioid receptor antagonist that can prevent the medication from working. This can increase your risk of serious side effects, such as slowed or difficult breathing, coma and death. Talk to your doctor or pharmacist before you take any other medicines.
People who use morphine for long periods of time may develop a physical dependence, which can cause withdrawal symptoms when the drug is stopped. Withdrawal symptoms are less common in people who only take morphine as prescribed by a doctor.
Addiction treatment is important for people who are dependent on opioids like morphine. It can help people who are addicted to regain control of their lives and break the cycle of addiction. Addiction treatment programs can include a range of behavioral health services, including individual and group counseling. They can also involve family and peer support groups, which can be helpful for people who are struggling to reclaim their lives after addiction.
Precautions
Morphine may cause serious and sometimes life-threatening breathing problems, especially during the first 24 to 72 hours of treatment or any time your dose is increased. This medication can also worsen slowed breathing in people who have asthma or certain other breathing problems. If you have a history of breathing problems, tell your doctor before taking this medicine. Morphine may also increase the risk of death in people who are being treated for a head injury or a spinal cord injury. Morphine may cause a dangerous buildup of carbon dioxide in the brain (CO2 retention). CO2 retention can lead to confusion, coma and other side effects. This medication can also cause a severe allergic reaction called anaphylaxis. This can be life-threatening and requires immediate medical attention. Get emergency medical help if you have symptoms of anaphylaxis, including hives, trouble breathing or swallowing, hoarseness, swelling of the face or throat, or wheezing.
This medication can cause drowsiness. Do not drive or operate machinery until you know how this medicine affects you. Morphine may also cause dizziness or lightheadedness when you get up from a lying position. Getting up slowly and resting for a few minutes before standing up can help to prevent this problem.
Long-term morphine use can cause constipation. To prevent this, drink lots of fluids and eat fiber.
Morphine can cause a severe reaction when mixed with alcohol or other depressants. Avoid consuming alcoholic beverages or other depressants while you are taking this medication.
If you are taking extended-release morphine tablets or capsules, do not chew, crush or break them. If you do, you will receive too much medication at one time, which can cause serious breathing problems and death.
This medication is available only with a prescription and can be given only by a trained health care professional. Do not share this medication with others. Keep this medication away from children and pets. Do not flush unused medication down the toilet or into water. Ask your pharmacist about a drug take-back program or dispose of this medication properly.
Morphine is a Schedule II controlled substance and may be subject to abuse and addiction. Morphine can cause physical or mental dependence, and withdrawal side effects may occur if this medication is stopped suddenly. Withdrawal symptoms include irritability, anxiety, sweating, difficulty falling or staying asleep, runny nose, dilated pupils, yawning, a feeling of being unwell, chills, and back or muscle pain. These symptoms can be prevented by gradually reducing the dose before stopping this medication.