About Morphine

Morphine is a powerful drug belonging to the class of opioids.  Morphine is classified as a controlled substance and requires a prescription in order to use or possess.

Morphine is used parenterally (by injection) for preoperative sedation, as a supplement to anesthesia, and for analgesia.  It is also the drug of choice for relieving pain of myocardial infarction and for its cardiovascular effects in the treatment of acute pulmonary edema.

Morphine may be prescribed for moderate to severe pain. It can relieve symptoms of pain by changing how your body perceives and reacts to pain.  Morphine is often prescribed for chronic pain outside due to active cancer treatment, palliative care, and end-of-life care.  Unfortunately, morphine is also a dangerous drug and overdosing can cause life-threatening reactions or even death.

Patients who are prescribed any type of narcotic for pain relief —  especially the elderly, should be carefully monitored in order to prevent adverse reactions and overdose.

Brand and Generic Names for Morphine

Traditionally, morphine was almost exclusively used by injection but is now available in many forms.  Morphine is marketed under generic and brand name products including:

  • MS-Contin®
  • Oramorph SR®
  • MSIR®
  • Roxanol®
  • Kadian®
  • RMS®
  • Arymo ER®
  • Astramorph®
  • Depodur®
  • Duramorphy®
  • Infumorph®
  • MorphaBond®

Morphine is available in oral solutions, immediate and sustained-release tablets and capsules, suppositories, and injectable preparations. In addition, the availability of high-concentration morphine preparations (i.e., 20-mg/ml oral solutions, 25-mg/ml injectable solutions, and 200-mg sustained-release tablets) partially reflects the use of this substance for chronic pain management in opiate-tolerant patients.

Morphine is the element in opium and can range in concentration from 4 to 21 percent. Commercial opium is standardized to contain 10-percent morphine. In the United States, a small percentage of the morphine obtained from opium is used directly (about 15 tons): the remaining is converted to codeine and other derivatives (about 120 tons). Morphine is one of the most effective drugs known for the relief of severe pain and remains the standard against which new analgesics are measured. Like most narcotics, the use of morphine has increased significantly in recent years. Since 1990, there has been about a 3-fold increase in morphine products in the United States. Source: Drug Enforcement Agency

Possible Side Effects of Morphine

In addition to the serious risks of addiction, abuse, and overdose, the use of prescription opioids can have a number of serious side effects, even when taken as directed.  The following are some of the side effects that can be caused by morphine use:

  • Changes in heart rate (faster, slower, or irregular beats);
  • Increased drug tolerance—meaning you might need to take more of the medication for the same pain relief;
  • Physical dependence—meaning you have symptoms of withdrawal when the medication is stopped;
  • Increased sensitivity to pain;
  • Constipation, nausea, vomiting, and dry mouth, loss of appetite, stomach pain or severe abdominal cramping due to spasms in the stomach or intestinal tract;
  • Difficulty urinating or pain during urination;
  • Sleepiness and dizziness
  • Confusion, depression, agitation or irritability, nervousness;
  • Auditory or visual hallucinations;
  • Low levels of testosterone that can result in lower sex drive, energy, and strength in men, and irregular menstruation in women;
  • Itching and sweating;
  • Muscle stiffness, loss of coordination
  • Seizures and twitching;
  • Fainting, loss of consciousness or unresponsive; and
  • Coma or death.

The active poisonous ingredient in morphine is morphine sulfate.  A large overdose can cause a person to stop breathing and die if medical attention or an antidote is not given right away. The person may need to be admitted to the hospital to continue treatment.

Signs and Symptoms of Morphine Overdose

  • A cold or clammy feel to the skin
  • Bluish hue in the fingertips and lips
  • Constricted (small) pupils, blurry vision
  • Nausea, vomiting, severe constipation
  • Severely slowed or irregular breathing
  • Slow heartbeat
  • Weakness, limp muscles
  • Severe sleepiness
  • Loss of consciousness, coma, and death

Treatment for a Morphine Overdose

The following information is what the health care provider will measure and monitor. Including the person’s vital signs, temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The health care team will closely monitor the person’s breathing. The person may receive:

  • Activated charcoal
  • Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
  • Blood and urine tests
  • Chest x-ray
  • EKG (electrocardiogram, or heart tracing)
  • Fluids through a vein (IV)
  • Laxative
  • Naloxone, a medicine (antidote) to reverse the effect of the poison, many doses may be needed

What to do If You Suspect Someone Has Overdosed

Remember:  If not treated quickly, a morphine overdose is likely to end in death.

Seek immediate medical help — call 911. DO NOT make a person throw up unless told to do so by Poison Control or a health care professional. Perform mouth-to-mouth breathing if the person stops breathing. If possible, determine the following information if doing so would not cause a delay in treatment (time is of the essence when treating most types of drug overdoses):

  • Person’s age, weight, and condition (for example, is the person awake or alert?)
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed

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