Morphine has become one of the most widely known medications for treating opioid dependence, but its own nature as an opioid can make it a double-edged sword for some patients. For people who become dependent on their morphine therapy and want to quit, the question of whether morphine withdrawal can be lethal is a significant concern.
By and large, withdrawing from morphine should not be a life-threatening experience. The Addiction journal notes that while the symptoms of withdrawal can be very unpleasant, they can be successfully navigated with adequate care and supervision.
An example of this is in the case of dehydration and malnutrition arising as a result of opioid withdrawal. When patients experience diarrhea and vomiting, they lose vital nutrients and fluids that lead to the development of dehydration and malnutrition; this may result in a weakened immune system, elevated blood sodium levels, and even heart failure if instant action is not taken.
In a proper treatment setting, this can easily be accounted for. A patient will be put on an intravenous drip to ensure they have the right nutrients and fluids, and they will be given antidiarrheal and antihistamines to reduce the vomiting and diarrhea, and thus stave off dehydration and malnutrition. The Addiction journal warns that “people can, and do, die from opiate withdrawal” (which includes morphine withdrawal). However, these fatalities are generally preventable.
Morphine is an opioid, and it a natural product of the seeds of the opium poppy plant, from which nearly all opioids are derived. Morphine is the most potent and abundant of the natural opioid products found in the poppy. Ever since its discovery, it has been a go-to pain reliever. In medical settings, morphine is used to treat moderate-to-severe levels of pain, and it is typically prescribed for an injury or post-surgical care.
As an opioid, morphine works when its opioid molecules attach themselves to the numerous opioid receptors in the brain and the central nervous system. This mechanism is how morphine dampens incoming pain signals to the CNS, so patients under the influence of morphine are offered some relief from their distress.
Also as an opioid, morphine induces feelings of very strong relaxation and tranquility, which is why it is effective as a painkiller.
Morphine, like any drug, comes with a number of side effects. Among them are:
Notwithstanding the discomfort of the side effects, morphine’s effectiveness in treating pain has made it a staple line of treatment for patients with chronic pain. However, this effectiveness comes with a price. Morphine itself is very habit-forming, compelling patients to want increasing amounts of the drug not just to keep their pain away, but also to experience more pleasure and calm than they have ever felt before. In many cases, this lures patients to seek out more opioids, and stronger opioids, like heroin.
For reasons such as these, morphine is a Schedule II substance in the United States; it has legitimate medical applications, but the risk of physical and psychological dependence makes it strictly prohibitive.
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Stopping morphine after developing a need for it is not a simple case of not taking anymore. With repeated exposure, the body and brain come to require increasing amounts of morphine to experience pleasure, freedom from pain, and also a basic level of functioning. Users who get so used to morphine at this point cannot go without it because doing so induces severely distressing withdrawal effects. These effects are the result of many systems in the body struggling to cope without the opioid molecules constantly activating the opioid receptors throughout the brain and central nervous system.
Morphine withdrawal symptoms include the following:
In cases of chronic morphine use and dependence, if the patient has other drugs in their system, or if the patient has a family history or risk factor for certain mental illnesses, other complications can arise from the withdrawal process.
How long the morphine withdrawal process takes place depends on many factors:
Additionally, every patient has different metabolisms, mental health balances, and physiologies. This means that withdrawal from morphine can be a very different experience for different people.
In general terms, people experience mood swings and agitation within 12 hours of their last morphine dose. After this comes what is usually the hardest part of the process for many: nausea, cramping, diarrhea, depression, anxiety, loss of appetite, insomnia, and deep desire for more morphine. These symptoms peak by the third day of the withdrawal process, and then abate by the fifth to the seventh day.
For some users, they have a less intense but more prolonged experience. It could last for as long as two weeks, but the symptoms are easier to manage.
People who have a family history of substance abuse or mental health illnesses, or who have co-occurring mental health and addiction problems of their own, might struggle with the psychological symptoms of withdrawal for weeks. This period is usually mitigated by techniques and strategies taught in recovery.
By the second week after the last dose of morphine, the majority of the physical symptoms have dissipated, but most patients still experience some lingering agitation and mood difficulties. There might also be issues with sleeping and feeling an occasional need for more morphine. This is entirely normal, and can it usually be countered with lots of rest, counseling, and some medication. However, this is also a very vulnerable time for many patients, and not receiving sufficient care during this period can result in relapse.
Morphine withdrawal has the potential to be a very dangerous experience, and for this reason, people should not attempt to withdraw from their morphine dependence on their own. It is best to seek out medical assistance from a hospital or drug treatment center, where professionals can make patients as comfortable and safe as possible during the process. This can entail providing a constant source of healthy food, guaranteed rest in a stable environment, and administering medications to ease the worst of the withdrawal symptoms.
Some people make the difficult choice to withdraw from morphine without assistance. This may be because they are scared or ashamed, or because they are worried that they do not have the finances to pay for treatment. These are understandable concerns, but they should not dissuade you from asking for help. Whatever the perceived downsides of assisted withdrawal are, it is always a safer option than withdrawing on your own.
If it is absolutely necessary to withdraw from morphine outside a treatment facility, there are certain steps you can take to ensure that the process is not lethal. For example, to avoid developing dehydration and malnutrition as a result of the vomiting and diarrhea of withdrawal, it is important to have healthy, consumable food on hand. Foods that are high in fiber, with complex carbohydrates (leafy greens, peas, beans, and whole grains) will reduce the severity of the symptoms, but nausea will make consumption and digestion difficult.
To that point, over-the-counter medications to ease nausea, such as Dramamine, can be taken. Patients can also get medicine to help with diarrhea, like Imodium. It is important to take those medications in the exact doses because the body is still vulnerable and recovering during the process.
Too much medication, even of the OTC variety, can upset the delicate balance that the patient needs to overcome the physical need for morphine. Similarly, sugary foods have little nutritional value and should be avoided during this time.
Regularly consuming fluids is also important to ensure than morphine withdrawal is not lethal. Water will help, as will drinks with a high electrolyte count; they have the right balance of electrolytes to restore the right fluid balance to the body, allowing for a more rapid and effective absorption, and countering dehydration. Fruit juice is also very good for dehydration, and fruits, in general, will help with malnutrition; they will reintroduce key vitamins that have been depleted by the withdrawal process.
One way to ease the stress of hydrocodone withdrawal is to boost endorphin production. Endorphins are natural chemicals, similar in composition to morphine, that are created by the body to manage pain while stimulating positive feelings. Physical exercise is a good example of this. While there is stress on the muscles and the joints, the release of endorphins give people a surge of power and well-being. This is not unlike the effect of opioids and narcotics; indeed, even the term “endorphin” is derived from “morphine.”
However, opioids are much stronger than endorphins. When people take morphine (or other opioids like oxycodone, hydrocodone, or heroin) for an extended period, the body loses the ability to produce its own endorphins, effectively rendering the person incapable of experiencing pleasure and managing pain without the presence of the morphine.
Removing morphine through the withdrawal process forces the long-dormant pituitary gland to resume its endorphin production. After being buried with the opioid molecules in morphine, it cannot do this without help. Giving the pituitary system a hand will help those who are struggling with the physical discomfort and negative feelings of withdrawal.
This can be done by taking part in pleasurable, but gentle, activities. Eating dark chocolate, for example, has a number of health benefits (including assisting in endorphin stimulating), but because of the delicate state of the stomach and bowels during withdrawal, chocolate consumption should be minimalized. Strawberries, oranges, and grapes will provide a similar benefit with fewer risks. Light exercise like yoga or even taking a walk around the block, exposure to sunlight, and even laughter will help the pituitary gland resume production of endorphins. This will help wean the person off the need for morphine to experience pleasure.
Morphine withdrawal should not be lethal. When it is conducted in a treatment center with medical supervision, it is very unlikely to be lethal. Treatment centers can offer long-term recovery plans, covering therapy, counseling, and peer-led aftercare support to greatly reduce the risk of relapse.
However, this is not always an option for some people, and they decide to withdraw from morphine on their own. Home-based remedies — vitamins and supplements, fluids and fruits, light activity to boost endorphins — can make this process easier, but people should always be ready to call for help if complications arise as a result of the morphine withdrawal.
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