The National Institute on Drug Abuse (NIDA) states that addiction is a chronic disease. As a complex disorder, it affects physical, mental, emotional, social, financial, and even legal stability. Addiction is often associated with substances like alcohol or drugs, but behaviors like gambling or sex can also trigger it.
Since addiction is considered a chronic condition, it requires long-term treatment. The effects of addiction to drugs or alcohol are often physical. Some may be acute issues, and some may lead to further chronic health problems.
The History of Morphine
Drugs related to opium are some of the most widely abused substances in the world, with millions of people struggling with addiction to both prescription and illicit narcotics. Opium itself was cultivated in Mesopotamia as early as 3400 B.C., and the history of opium consumption involves using the drug as a pain-killing medical treatment and abusing it recreationally to get high.
Since opium triggered compulsive behaviors but was also a useful medication, researchers began to develop different solutions and versions of the substance to get the most benefit with the least addiction potential. In 1803, morphine was invented. It was the first synthetic opioid, derived from the opium poppy.
As the original synthetic narcotic, morphine was used widely in medical treatment, especially during the Civil War; however, it was soon found to be more potent than opium and trigger addiction. Other synthetics, starting with heroin, were derived from opium after that.
Modern prescription opioids like oxycodone, codeine, and hydrocodone come from morphine. Medical researchers still seek the right combination of analgesic properties with lower addiction risk.
While there are dozens of prescription and illicit narcotics available now, morphine still has an important medical use and is prescribed to manage pain. If you are prescribed morphine to treat moderate or severe pain, or you struggle with morphine addiction, it is important to know the risks, side effects, and potential for long-lasting effects on you physically and mentally.
What is Morphine?
Morphine is a generic opioid drug that is available for prescription under several brand names. As an opioid medication, it is prescribed to alleviate moderate to severe pain. Morphine binds to the opioid receptors in the brain, which are located in the nucleus accumbens. This not only relieves pain signals traveling up the spinal cord, but also suppresses the breathing rate and releases dopamine and serotonin, which leads to a sense of relaxation, increased drowsiness, and potentially a euphoric high. Dopamine and serotonin elevate mood, and dopamine in particular triggers the brain’s reward system, which can lead to compulsive behaviors and addiction.
What Is Cut With Morphine
Morphine that is purchased through dubious means is sometimes cut with other substances to make the high more intense, to make the drug stronger, or to increase dealer profits.
Cocaine
This is known as “speedballing.” The National Institute on Drug Abuse hosts information about cocaine combined with heroin, but mixing cocaine with morphine is also called speedballing, and has similar effects. This is dangerous because opiates are depressants and cocaine is a stimulant. Their opposing forces can put a strain on the body.
Speedballing is usually done on purpose. Some who mix cocaine and morphine, or who buy morphine tainted with cocaine and vice versa, believe that cocaine’s stimulating effects may counteract the effects of morphine. However, this mixture is known to cause respiratory issues because morphine’s effects last longer than those of cocaine.
Fentanyl
More data is needed for morphine specifically, but an April 2018 report from The Gazette shows that counterfeit prescription opioids are becoming a public health concern. People dependent on it and choose to buy prescription pills online may wind up with drugs tainted with fentanyl, which can be between 50 to 100 times more potent than heroin. Counterfeit pills contaminated with this substance were linked to overdose deaths in 2016.
Carfentanil
The U.S. Drug Enforcement Administration says carfentanil is anywhere from 100 times stronger than fentanyl to 10,000 times stronger than opioids like morphine. It must be handled with absolute care regardless of how it is used. Though more data is needed, carfentanil can sometimes be found in counterfeit pills, and it could turn up in tainted supplies of morphine.
What If I Am Prescribed Morphine?
If you struggle with moderate-to-severe pain from an injury or illness, or if you have recently had surgery that will take some time to heal, you may be prescribed morphine to manage the intensity of pain. It is important to follow your doctor’s orders closely, including avoiding alcohol, other opiates, other sedatives or muscle relaxants, or illicit drugs while you are taking this prescription medication.
If you are taking other medications, be sure to talk to your doctor about potential side effects or interactions while you take morphine. If you have a history of substance abuse, make sure your doctor knows this, too. They can help you manage a morphine prescription and avoid relapse or addiction to this drug.
Taking more morphine than prescribed, taking it more often than prescribed, or mixing it with other substances increases acute and chronic health risks. The biggest risk associated with morphine misuse or abuse is a drug overdose, which can be deadly.
If you or someone near you overdoses on morphine, call 911 immediately. Signs of a morphine overdose include:
Signs Of A Morphine Overdose
- Confusion and delirium
- Stumbling or a loss of motor control
- Clammy or cold skin
- Bluish tint to the skin
- Limp body
- Passing out and not being able to wake up
- Nausea or vomiting
- Slow or weak heartbeat
- Depressed, decelerated, irregular, or stopped breathing
The greatest risk from overdosing on morphine is oxygen deprivation from being unable to breathe. This is a serious, life-threatening situation that requires emergency medical attention.
What Side Effects Does Morphine Cause?
Even taking morphine as prescribed can lead to some side effects. Side effects are associated with opioid consumption, some of which are more common, while others are rare. Common side effects include:
Morphine Side Effects
- Stomach cramps, nausea, vomiting, and constipation
- Drowsiness, sedation, and sleeping a lot
- Lightheadedness or dizziness
- Increased sweating
Less common side effects include:
Less Common Side Effects
- Blurred vision
- Chills
- Confusion
- Fainting
- Decreased urination
- Headaches
- Agitation
- Fever
- Unsteady walk
- Unusual tiredness or weakness
- Cramps or muscle spasms
The riskiest side effect is getting high from morphine. Many people may feel intoxicated when they take morphine, especially if they have not taken opioid drugs before. However, some people may find this intoxication pleasant, which may lead to misuse of the prescription and then addiction to the drug.
Are There Long-Lasting Side Effects?
The most harmful long-lasting side effect from taking morphine is the risk of addiction. If you follow your doctor’s instructions regarding morphine, your risk of addiction to the drug is low; however, if you misuse the drug or take it for nonmedical reasons, you could develop an addiction to this substance that requires specific medical treatment through detox and rehabilitation.
Like short-term side effects, taking morphine to treat chronic pain can also lead to some long-term side effects that can impact your life. Taking any opioid medication consistently for a long time can cause chronic issues in parts of the body.
Gastrointestinal system: Constipation is one of the most widely reported and complained about side effects from taking morphine or related opioid drugs. Between 40 percent and 45 percent of patients on opioid therapy report struggling with constipation. About 25 percent experienced nausea, which affects appetite and can further change the digestive system. A doctor likely will prescribe laxatives, but chronic constipation can damage the bowels, leading to vomiting, bloating, and abdominal bleeding. Orally consumed opioids like morphine may also lead to ulcers.
Respiratory system: An acute risk of abusing too much morphine involves suppressed breathing, which can lead to oxygen deprivation and death. Over time, regular doses of morphine can mildly suppress breathing, which also causes oxygen deprivation, but chronic low levels of oxygen are harmful in a different way. They can damage the brain, lungs, and heart, among other organs. About 10 percent of people taking opioids long-term experience hypoxemia, or blood oxygen saturation levels of less than 90 percent. It is also important to note that physical tolerance to analgesic effects and euphoric effects does not necessarily parallel tolerance to respiratory effects. Misusing or abusing morphine can lead to deadly respiratory depression even if you do not feel intoxicated.
Cardiovascular system: A study of Medicare patients with arthritis, who were receiving opioids for chronic pain, found that about 77 percent had an increased risk of cardiovascular events like myocardial infarction and heart failure. The risk increased the longer opioid drugs, including morphine, were taken. During the first month of treatment, risks were no different than the control group, while after 180 days of opioid treatment, different opioids increased the risk of heart problems at different rates.
Central nervous system (brain and spinal cord): Because morphine and other opioids release endorphins, dopamine, serotonin, and norepinephrine, long-term consumption of these drugs can change structures in the brain that interact with, and rely on, these neurotransmitters. Mood disorders increase. For example, about 38 percent of people who take opioids for a long time have comorbid clinical depression.
Ongoing opioid therapy also paradoxically increases the risk of hyperalgesia or increased pain sensations. People who take morphine or related medications for six months or more to treat moderate or severe pain are more likely to feel higher levels of pain if and when they stop taking morphine. Increased pain sensitivity is one of the leading reasons that doctors are prescribing opioids at lower rates in addition to the high risk of addiction.
Musculoskeletal system: Dizziness from low blood pressure leads to an increased risk of fainting and falling while taking morphine, which increases the risk of bone fractures from an injury. Taking opioids for a long time is also associated with muscle weakness and less muscle tone, which may be due to lethargy, feeling ill or dizzy consistently, or chronic hypoxia.
Endocrine system: Hormone regulation changes the longer opioids like morphine are consumed. Both male and female hormones are affected, leading to a lower sex drive and reduced fertility.
Morphine and other opioids also impact the body’s management of all other hormones, including thyroid and metabolism hormones, growth hormones, adrenaline, and pituitary hormones. This can change one’s mood, appetite, and physical growth, among other effects.
Immune system: Morphine and fentanyl, in particular, hurt the immune system. They can suppress one’s immune response, leading to an increased risk of illness and infection. The cause is believed to be interaction with the mu-opioid receptors in the brain, which regulate all immune cells. The impact on the pituitary and adrenal glands also changes how the immune system responds to infections.
When Should I Talk To My Doctor About Side Effects?
Serious side effects may require emergency medical attention, especially when an overdose or allergic reaction is the issue. Otherwise, uncomfortable side effects may need prescription help. Again, the most common side effect is constipation, which should be treated with laxatives or fiber supplements, as it can be harmful.
You should always discuss concerns about your medication and its side effects with your doctor. Short-term side effects are managed differently from long-term effects, and it is important to know which side effects may be risky for you.
How Long Does Morphine Stay In The Body?
Morphine’s half-life is between 1.5 to 4.5 hours, although it can remain present in the body for longer if extended-release versions were taken. This means it can take eight to nine hours for morphine to metabolize out of the body completely.
If you quit taking morphine, you may develop withdrawal symptoms after eight hours, as the drug completely leaves your body, if no replacement dose follows that. Withdrawal symptoms are associated with physical dependence on a substance. You might experience withdrawal symptoms if you took morphine as prescribed because your brain may become reliant on the presence of the drug, but you may not crave it or abuse it. However, if you do develop an addiction to morphine and compulsively take larger doses of it over time, you are more likely to experience withdrawal symptoms after morphine is eliminated from your body.
Working with a detox program that has medical supervision from a physician can ease the morphine withdrawal process. During detox and rehabilitation, you may be tested for drugs consistently so that your doctor can understand how long you took a substance, how long it is taking to leave your body, and if you have relapsed. Drug testing is also important for law enforcement proceedings and workplace safety.
There are several different kinds of drug tests. Urine tests are the most often used, but blood, saliva, hair, fingernails, and even sweat can all be analyzed for intoxicants.
Morphine Overdose Symptoms: Potentially Deadly
As the original synthetic opioid, morphine overdose symptoms are like those of other opioid painkillers and illicit narcotics. Shared symptoms of overdose include:
Symptoms Of Overdose
- Spasms of the stomach or intestinal tract
- Drowsiness or sleepiness
- Pinpoint pupils
- Confusion or disorientation
- Passing out
- Breathing changes
- Cold or clammy skin
- A bluish tint to the skin
- Stopped breathing
The opioid receptors in the brain trigger pain relief and a release of neurotransmitters that may trigger the reward system. In addition, they also change breathing. This effect was a reason that codeine and milder opioid drugs are sometimes in cough syrups.
In larger doses or more potent drugs like morphine, breath suppression can happen consistently, leading to oxygen deprivation that may change brain function over time. If it occurs rapidly, it can lead to stopped breathing and death from oxygen deprivation.
Opioid abuse and addiction lead to numerous fatal overdoses all over the world. In the United States, as of 2016, an estimated 115 deaths from fatal opioid overdoses occur every day.
If you see someone experiencing these symptoms, especially if the person is passing out, looking extremely sedated, or struggling to breathe, call 911 because they need emergency medical attention. Each moment counts in this situation.
Is Morphine Dependence the Same as Addiction?
No, dependence and addiction are separate conditions. While many people who become addicted to morphine develop a physical dependence on it, you may develop a physical dependence on your prescribed dose of morphine without craving the drug, compulsively misusing or abusing it, or purchasing it illegally online or on the black market to get high.
“Since morphine, like other opiates, releases neurotransmitters involved in mood regulation, your brain may become used to the presence of morphine when regulating these chemicals. If you no longer need morphine to manage pain, and you quit taking it suddenly, you may develop withdrawal symptoms, even though you are not technically addicted to the drug. Consult your doctor before stopping use.”
If you struggle with morphine addiction, the first step is to enter detox treatment. If you took morphine to treat chronic pain but now abuse the drug, your doctor can help you manage addiction symptoms while also continuing pain treatment.
Rehabilitation is the next step after detox. Evidence-based rehabilitation programs should include behavioral therapies such as group and individual therapy, and they will likely include family therapy, mindfulness practices, and other helpful approaches to managing stress.
Can Morphine Withdrawal Be Lethal?
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.
“However, if the patient has certain pre-existing health conditions, it is likely that the withdrawal will cause emergency complications, and it is possible that those complications can be lethal.”
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.
What To Look For in a Detox Center
A medical detox program can provide the highest level of care during morphine withdrawal. When seeking a detox center, it is important to understand exactly what it is offering.
Comprehensive medical detox programs are typically inpatient where a person will remain on-site for five to seven days while morphine safely processes out of the body. Outpatient detox programs may provide substitute medications once per day or so.
A detox center should perform a detailed assessment before admission to tailor the program to the individual. Any co-occurring disorders will need to be addressed, and integrated care, as well as simultaneous treatment, will need to be arranged. Staff at a detox center should be highly trained, licensed professionals and the center itself should also be licensed and accredited.
Personalized care is important. Addiction is a disease that impacts each person in their own way, and treatment should address this level of individuality. The goal of detox is not just for morphine to safely process out of the body, but also to provide a strong foundation for recovery. In this way, a detox program should be followed with a complete addiction treatment program focused on minimizing relapse and providing tools for doing so.
Detox programs that are seamlessly integrated into comprehensive treatment programs can offer a full continuum of care. In a safe and secure environment, morphine withdrawal can be completed, helping to pave the way to recovery.
