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What is Morphine?
Morphine is a prescription opioid (narcotic) that is used to treat moderate to severe chronic pain. It is available in both short-acting and extended-release (XR) forms. Morphine should only be used under the supervision of a doctor who can adjust your dosage and the length of prescription, as needed.
Morphine is highly addictive and there is a high risk of abuse. It alters how the brain and nervous system respond to pain. So, stopping morphine after a dependency has developed (without gradually tapering the dosage) is extremely difficult.
The Risk and Dangers of Morphine Use
There are risks and dangers associated with the use of morphine. These include:
- Side effects (from minor to severe)
These risks may occur because of intentional misuse of the drug, or they may occur unintentionally. Most cases of addiction cases begin innocently before they end up as a full-blown addiction.
Morphine Side Effects
Mild side effects are usually not a cause for concern, but severe symptoms can result in a need for medical attention.
Common side effects include:
- Drowsiness (nodding out)
- Stomach pain and cramps
- Dry mouth
- Mood changes
- Small (pinpoint) pupils
- Difficulty urinating or pain when urinating
More serious side effects of morphine that require immediate medical attention include:
- Reduced breath rate with long pauses between each breath or any difficulty breathing
- Purplish or blue skin hue
- Increased heartbeat
- Chest pain
- Loss of coordination
- Hoarse voice
- Drug Interactions
- Sweating or shivering
- Severe muscle stiffness or twitching
- Any effect on sexual activity
- Nausea, vomiting, diarrhea, or reduced appetite
- Skin reactions including hives, rash, or itching
- Swelling of the eyes, face, lips, mouth, or throat
Morphine comes in different forms and may be abused by oral ingestion, by injection, or through snorting. When snorted, blood vessels found in the nose take the drug straight to the bloodstream, thereby producing a more intense and immediate effect.
Dependency and withdrawal are possible regardless of whether a person is using morphine by prescription or recreationally. Dependency develops faster when someone is abusing morphine with larger-than-recommended doses.
Morphine abuse also occurs when someone uses the drug:
- Without a prescription
- To get high
- With alcohol or other drugs intended to enhance the effect
- More frequently than recommended
- Attempts to obtain the drug or more of the drug through manipulation or illegal means
People who receive legal morphine prescriptions ultimately switch to heroin once they start abusing the drug. Heroin is a cheaper alternative and is easier to obtain.
Morphine is an opioid, and opioid addiction has a significant impact on the body. Opioids alter the brain's perception of pain. Instead of discomfort, users feel euphoria. Additionally, morphine has a sedative effect. These sensations are what cause addiction because the user wants to experience these over and over again.
Here are some signs of morphine addiction:
- Going doctor shopping in a short period of time
- Selling things and/or stealing to buy morphine
- Disappearing or hiding from family and friends so they don't find out about the addiction
- Irregular eating and sleeping patterns
- Significant weight loss
- Exhibiting withdrawal symptoms
Withdrawal will occur regardless of whether a person was abusing the drug if they are physically dependent. Withdrawal intensity varies from person to person, based on several factors, including:
- Amount and method of use
- Length of time abusing the drug
- Simultaneously abusing other drugs
- Previous unpleasant experiences with withdrawal
- Existing medical or mental health issues
Morphine withdrawal symptoms occurring within the first few days of the last dose include:
- Muscle twitches
- Muscle aches
- Difficulty sleeping
- Bone pain
- Heavy sweating
- Runny nose and teary eyes
- Dilated pupils
- Gastrointestinal discomfort and stomach cramping
- Nausea and vomiting
- High blood pressure
- Fast pulse rate
- Fast breathing rate
Most of the above symptoms will diminish as time passes, but some will linger, and new symptoms associated with post-acute withdrawal syndrome (PAWS) could develop. These include:
- Sleep problems
- Low energy and fatigue
- Feeling emotionally numb
It is possible to overdose on morphine. People who are prescribed morphine by their doctors often receive a rescue medication (known as Naloxone) that reverses the potentially fatal effects of an overdose. Naloxone blocks the effects and relieves the dangerous symptoms triggered by an overdose.
Symptoms of overdose include:
- Slow, shallow, or irregular breathing
- Loss of consciousness
- Limp muscles
- Cold, clammy skin
- Contracted pupils
- Reduced heart rate
- Blurred vision
Morphine is a physically addicting drug. This means a physically dependent person will experience withdrawal if and when they stop using the drug.
Interactions and Contraindications
Morphine interacts with certain medications, and people taking them should not use the drug. This includes opioid analgesics and opioid antagonists. It’s also important that people using morphine do not consume alcohol because it can trigger a severe reaction.
The combination of morphine and the following medications and substances can trigger a serious interaction:
- Sodium oxybate
- Drugs that cause respiratory depression
Certain medications trigger moderate interaction when used in combination with morphine. Make sure your doctor is aware of all the medications you are taking before using morphine (both prescription and over-the-counter).
There are also contraindications to using morphine. The prescribing doctor should be informed if a person:
- Is younger than 18 years old
- Is allergic to morphine
- Has severe breathing problems, asthma, or sleep apnea
- Has been diagnosed with brain tumor
- Has liver or kidney disease
- Has pancreatitis
- Has a head injury and/or experiences seizures
- Has an alcohol or drug addiction
- Has a mental health disorder like depression or generalized anxiety disorder (GAD)
- Has a blockage in the intestines or stomach
- Is pregnant and/or breastfeeding
- Has used a MAOI in the past 2 weeks. Examples of MAOIs include tranylcypromine, selegiline, rasagiline, phenelzine, methylene blue injection, linezolid, isocarboxazid, and many more.
Detoxing From Morphine
Stopping morphine once an addiction develops usually isn’t life-threatening, but it is very unpleasant. However, there are some instances in which withdrawal is a very serious medical issue.
Severe dehydration from vomiting and diarrhea can occur. Those with pre-existing heart conditions or anxiety disorders might also develop medical emergencies during withdrawal.
Medically assisted detoxification is essential for these people and is recommended for anyone with a morphine addiction. Professional detoxification reduces or eliminates symptoms of withdrawal and reduces the risk of relapse.
Treatment Options for Opioid Abuse & Addiction
Opioid use disorder is difficult to overcome. Fortunately, there are several options for help. These include:
- Medication-Assisted Therapy (MAT) — When it comes to medication-assisted therapy for opioid use disorder, there are three types approved: buprenorphine, methadone, and naltrexone. Buprenorphine and methadone help manage withdrawal symptoms as you detox. Naltrexone blocks the receptors that opioids bind to, making it impossible to get high from them. Medication-assisted therapy is most effective when combined with other therapies.
- Inpatient Programs — Inpatient programs are the most intensive addiction treatment options. These programs guide you through medical supervised detoxification, behavioral therapy and other services such as medication-assisted therapy. They typically last 30, 60 or 90 days, but may be longer if necessary.
- Partial Hospitalization Programs (PHPs) — Intensive outpatient programs are the next level of addiction treatment, providing similar services to inpatient programs such as detoxification and behavioral therapy. The difference is that the patient will return home to sleep, and some programs will include transportation and meals. PHPs are ideal for both new patients as well as those who have completed inpatient treatment but still need intensive care.
- Outpatient Programs — Outpatient programs provide a well-rounded treatment program for people with a high motivation to recover. These programs are flexible and can be made around for your schedule, and can be customized to work best for you. These programs work for new patients as well as those that complete an inpatient or partial hospitalization program.
Morphine addiction treatment tends to be long-term, with some residential programs lasting up to a year and outpatient therapy continuing indefinitely.