Last Updated Dec 2, 2021
Morphine is used to help control moderate to severe pain. Although it does have legitimate medical purposes, it has significant abuse potential and should be used with care.
What Is Morphine?
Morphine is an opioid analgesic, a type of painkiller used for pain relief. It is also an opioid that is directly extracted from poppy plants, as opposed to being a synthetic opioid, such as fentanyl, which is synthesized in a lab.
All opioids have significant abuse potential if misused and should only be taken as prescribed. If misused regularly, morphine can rapidly lead to dependence and addiction.
Morphine is used to treat moderate to severe pain. Extended-release morphine tablets and capsules are only used for severe pain when other pain controller options aren’t available or would be inadequate.
Morphine is often thought of as the “default” opioid, against which other opioids are compared when measuring strength and determining use cases.
While this medication has several legitimate medical applications, doctors are careful when prescribing morphine or any other opioid due to the associated risks, discussed in more detail below. Even more so than with other types of prescription drugs, opioids are usually only prescribed as needed and for as short a time as necessary.
Dosages for opioids usually begin low and are slowly raised, with the intention of finding the lowest possible dose that provides the necessary pain relief.
When possible, daily dosages are kept below 50 morphine milligram equivalents (MME) a day, as dosing at or above this level has been shown to significantly raise a person’s risk of overdose. Dosing above 90 MME is rare, at least for the purpose of pain relief.
For context, 1 morphine milligram equivalent is any amount of a given opioid that is equal in strength to 1 milligram of morphine. While these calculations will almost always be done for you, a doctor uses this measurement to compare opioids more easily.
Because the base opioid for this conversion system is morphine, no conversions are needed when prescribing morphine — 1 milligram of morphine is equivalent to 1 milligram of morphine.
Effects of Morphine
Morphine has several effects, which are similar to the effects of most other opioids:
Opioids act on opioid receptors in the brain, binding to them. This has a number of important effects, blocking pain signals sent to the brain and also triggering the release of dopamine. Dopamine is a key part of the brain’s reward system, and this can cause an intense, pleasurable high when the drug is misused.
While the brain also naturally produces its own opioids, research has shown these natural substances have some significant differences in how they affect the body and brain.
Morphine and other opioids can also cause a number of side effects, including these:
- Difficulty urinating
- Dry mouth
- Mood changes
- Pupil dilation
- Stomach pain
One of the most serious effects opioids have in the short term is on respiration. Opioids depress a person’s breathing, causing them to take in less oxygen. This effect is generally the primary danger when the drug is misused, with an overdose potentially causing a person to be unable to take in enough air. The signs of an overdose are discussed more below.
Opioid use has significant potential to cause physical and psychological dependence, especially if the drugs are misused. If a person suddenly stops taking morphine after a period of use, they may experience withdrawal, which is characterized by a variety of flu-like symptoms and potentially intense cravings for opioids.
There is evidence of several long-term effects of opioid use, even in a therapeutic context, including a higher risk of the following:
- Hypothalamic-pituitary-adrenal dysregulation
- Sleep-disordered breathing
Opioids have an incredibly high abuse potential, illustrated by the significant opioid addiction crisis the United States is currently experiencing. If doctors and patients are not careful, opioids have the potential to significantly damage a person’s quality of life, causing them to struggle with addiction. While possible to overcome, addiction represents a long-term health concern that can affect many facets of a person’s life.
Morphine and other opioids also have a significant risk of overdose when misused, especially if taken with other drugs that can suppress respiration, such as alcohol or benzodiazepines. If someone is taking high doses of opioids, they should always have naloxone (Narcan) on hand.
Signs of an Opioid Overdose
An opioid overdose is a life-threatening emergency. Signs of an opioid overdose include the following:
- Blue or purple lips or fingernails
- Extremely pale or clammy skin
- Inability to awaken or remain awake
- Inability to speak
- Limp or very weak body
- Slowed or stopped breathing
- Slowed or stopped heartbeat
If a person is experiencing any of the above symptoms, or any other symptoms that seem severe even if not listed above, call 911 immediately. If available, naloxone can be administered to a person overdosing on an opioid, including morphine. Naloxone will rapidly reverse the effects of the opioid, temporarily reversing the overdose.
If a person has stopped breathing or their breathing is labored, begin CPR while waiting for emergency responders to arrive.
Signs of Morphine Abuse & Addiction
The signs of drug abuse and addiction aren’t always easy to recognize in a loved one or even yourself. Broadly, a person has a problem with drugs if they misuse them regularly and can’t stop, even though drug misuse begins to negatively impact their health and other aspects of their lives.
Some common signs of morphine or any opioid misuse include the following:
- Inability to control opioid use
- Increase in risky behaviors, such as stealing
- Isolation from friends and family members
- Lowered libido
- New financial difficulties
- Strong cravings for opioids
- Weight loss
- Worsening of basic habits, such as hygiene and sleep
As briefly mentioned earlier, morphine withdrawal is characterized by flu-like symptoms as well as a strong craving for opioids.
Early withdrawal symptoms may include the following:
- Increased tearing
- Muscle aches
- Runny nose
Late withdrawal symptoms may include the following:
- Abdominal cramps
- Dilated pupils
Opioid withdrawal isn’t usually life-threatening, although in extreme cases it can be, such as if a person were to choke on their vomit or become severely dehydrated without properly replacing fluids lost through vomiting, sweating, and diarrhea.
If you have been misusing opioids for a while or regularly use high doses, get help before you stop taking them. Medical detox is the best step so professionals can help you safely stop taking the drugs, reducing the severity of your withdrawal symptoms and reducing your risk of relapse.
Addiction Treatment Options
If you or a loved one struggle with addiction to morphine and other opioids, you have several treatment options available.
Medication-assisted treatment (MAT) is generally the front-line treatment for opioid use disorder. You’ll take medication, such as buprenorphine or methadone, which will keep withdrawal symptoms and cravings under control while you participate in therapy.
In rehab, you will want to talk to an addiction specialist about making a treatment plan customized to your needs. You will need addiction counseling, and many people benefitting from a mix of individual, group, and family therapy.
Support group participation, such as attendance at 12-step meetings, is often part of the recovery process. You’ll build a strong support system in recovery, so you know where to turn when you are tempted to relapse.
Though morphine addiction can be intense, you can successfully manage it with the right help. Take the first step toward a better life today.
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Signs of Opioid Abuse. John Hopkins Medicine.
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