Morphine Withdrawal & Detox

Morphine withdrawal might better be called opioid withdrawal, as that is the type of medication morphine is classified as. When someone who is dependent on morphine suddenly stops taking it, they’ll experience distressing flu-like symptoms. [1]

While not usually life-threatening, morphine withdrawal symptoms can be very uncomfortable and can lead to relapse in order to alleviate these symptoms. The length of morphine withdrawal depends on the type of formulation someone has become dependent on—short-acting morphine will have a shorter withdrawal timeline than long-acting morphine. [1]

The recommended treatment setting for morphine withdrawal is medical detox, which involves 24/7 care, supervision, and monitoring to ensure the patient’s safety. Medical detox involves opioid withdrawal medications, such as methadone or buprenorphine, as well as supportive care and counseling.

What Is Morphine Withdrawal?

Morphine withdrawal can occur both in people who have only used morphine as prescribed and in people who abuse morphine and other opioids. 

Morphine withdrawal occurs as a result of the body becoming dependent on this opioid. This means the person needs to keep taking morphine in order to function normally. If they abruptly reduce their dose or stop taking it, they will experience distressing withdrawal symptoms, such as flu-like symptoms.

Symptoms are generally more severe in those who have abused morphine rather than only taken it as instructed by a medical professional. Becoming dependent on morphine is a normal adaptation to the ongoing presence of the substance, so if you are taking it for medical reasons, don’t suddenly stop—talk to your doctor about creating a tapering schedule so you can gradually quit.
Meanwhile, if you are addicted to morphine, you will likely need a medical detox program that occurs 24/7 care to ensure your comfort and safety during detox.

What Makes Morphine Withdrawal & Detox Different?

Opioids like morphine attach to opioid receptors in the brain, spinal cord, and other organs. When they’re active, they block pain signals and cause cells to release large amounts of dopamine. The result is an enhanced sense of relaxation and well-being.[2]

When opioids wear off and dopamine levels return to normal, people often feel slightly anxious and cranky. Since opioids work directly on the brain’s reward system, some people crave more drugs when their first hit wears off.

Morphine withdrawal is different. Withdrawal symptoms are often described as flu-like, and they can include physical symptoms like chills, runny nose, and abdominal distress.[6] In general, withdrawal syndrome is more severe than what a person might experience when a morphine dose wears off.  

Short-acting forms of morphine can cause withdrawal symptoms within eight to 24 hours after the last use, while long-acting versions cause symptoms within 12 to 48 hours of last use.[4] This late onset of symptoms sets withdrawal apart from normal use. You may feel sober for long periods before withdrawal starts.

Morphine Withdrawal Symptoms

All opioids typically have the same or very similar withdrawal symptoms associated with them. If withdrawing after becoming dependent on morphine, you can expect the following symptoms:[6]

• Sleep issues
• Cold flashes
• Goosebumps
• Uncontrolled leg movements
• Muscle pain
• Bone pain
• Diarrhea
• Nausea and vomiting
• Opioid cravings
• Runny nose
• Watery eyes
• Changes in body temperature
• High blood pressure
• Agitation
• Disorientation
• Headache

Opioid withdrawal isn’t generally life-threatening, although it can be extremely uncomfortable and harmful. And severe diarrhea and vomiting can lead to dehydration and electrolyte imbalances. It is important to drink water and electrolyte drinks to hydrate during withdrawal.

Protracted or Post-Acute Withdrawal Symptoms

Protracted withdrawal symptoms involve symptoms that linger after acute morphine withdrawal has resolved. These symptoms can last for weeks, months, or even a year after quitting morphine. These post-acute withdrawal symptoms may include: [3]

• Depression
• Anxiety
• Sleep disturbances like insomnia
• Irritability
• Fatigue
• Emotional blunting
• Focus and attention issues

These symptoms can fluctuate in severity and flare up due to stress. Post-acute withdrawal symptoms are one of the reasons it’s so important to receive ongoing therapy and support and reduce your risk of relapse.

What Affects Withdrawal Intensity?

Withdrawal intensity and severity is affected by many factors, such as these:

• Dose of morphine taken
• How long you’ve been taking morphine
• Whether you use other drugs
• If you quit cold turkey or receive medical detox
• Individual physiology
• Previous withdrawal experiences
• Comorbid medical conditions
• Co-occurring mental health disorders
• Kidney and liver functioning

How Long Does Morphine Withdrawal Last?

How fast-acting a drug is affects its withdrawal timeline, and morphine comes in many different formulations, including:

• Immediate-release tablets and capsules
• Immediate-release liquid
• Extended-release capsule and tablet
• Injectable preparations

Withdrawal symptoms from short-acting versions of morphine come on quicker and have a shorter timeline than long-acting morphine withdrawal.

Short-acting morphine withdrawal symptoms may appear within 8 to 24 hours after last use and may last up to 10 days.[4]

Long-acting morphine withdrawal symptoms may appear within 12 to 48 hours after stopping use and last for up to 20 days.[4]

Regardless of the formulation, protracted withdrawal can last for months or even years after a person has gone through acute morphine withdrawal.[3]

During protracted withdrawal, withdrawal symptoms are less severe. A person generally experiences cravings for opioids during this phase, so it’s important to continue therapy and other supportive approaches to prevent relapse.

When a person attends medical detox, which involves medications like methadone or buprenorphine, the withdrawal timeline changes. It may be longer as someone is administered an opioid withdrawal medication and then gradually tapered off it.

Morphine Withdrawal Management: Detox Programs

If you have a severe addiction to morphine or other opioids, medical detox is recommended. Medical detox may occur in settings like:

• Hospital
• Freestanding detox center
• Within an opioid addiction treatment program

Medical detox for morphine withdrawal typically involves the following:

• 24-hour care, supervision, and monitoring
• Withdrawal medications, such as methadone or buprenorphine
• Supportive care, such as IV fluids
• Nutritional therapy
• Detox counseling
• Case management and wraparound services

The National Institute on Drug Abuse says medications for opioid withdrawal and addiction are safe and effective. Several options are available for medical detox, including the following:[7]

• Opioid receptor agonists: Medications like methadone attach to opioid receptors and block withdrawal symptoms.
• Partial opioid agonists: Medications like buprenorphine attach loosely to opioid receptors and ease cravings.
• Adrenergic receptor agonist: Medications like lofexidine can alleviate withdrawal symptoms.

Some of these medications (like methadone and buprenorphine) can be used for the long term to keep relapse risks low. Others (like naltrexone) can’t be used for detox, but they can be used for long-term treatment of addiction.[7]

Your treatment team will create a follow-up plan for you and help transition you into a morphine addiction treatment program. Medications and therapy will be part of your care plan.

Rehab will help you address the factors that influenced your morphine abuse in the first place and will equip you with the coping skills you need to maintain recovery in the long run.