Patricia Beier
Fact Sheet on Morphine
Moraine Park Technical College
Jerry Van Kirk, M.Div., Th.M., ICS
Opiates
Opiates are a class of medications used for management of moderate to severe pain.
They act on what are called “opiate receptors” in the nervous system and the brain, and
diminish the experience of pain by the person. Medications in this class that are
commonly used by experts in pain management are:
Single drugs (used for control of moderate to severe pain) such as:
• Morphine (e.g., Roxanol, MS Contin, Kadian)
• Oxycodone (e.g., Oxycontin)
• Fentanyl (e.g., Duragesic patches, Actiq)
• Hydromorphone (e.g., Dilaudid)
• Methadone (e.g., Dolophine)
Many of these drugs come in both short-acting (lasting for 3 to 6 hours) and long-acting
(lasting from 8 hours to 3 days, depending on the type of opiate) forms.
Combination drugs (used for control of moderate pain) such as:
• Codeine/Acetaminophen combinations (e.g., Tylenol #2, 3, or 4)
• Hydrocodone/Acetaminophen combinations (e.g., Vicodin)
• Hydrocodone/Ibuprofen combinations (e.g., Vicoprofen)
• Oxycodone/Acetaminophen combinations (e.g., Percocet)
• Oxycodone/Aspirin combinations (e.g., Percodan)
These all last about 4 to 6 hours.
Withdrawal
The time it takes to become physically dependent varies with each individual. When the
drugs are stopped, the body needs time to recover, and withdrawal symptoms result.
Withdrawal from opiates can occur whenever any chronic use is discontinued or reduced.
Some people even withdraw from opiates after being given such drugs for pain while in
the hospital without realizing what is happening to them. They think they have the flu,
and because they don't know that opiates would fix the problem, they don't crave the
drugs.
Early symptoms of withdrawal include:

Agitation

Anxiety

Muscle aches

Increased tearing

Insomnia

Runny nose

Sweating

Yawning
Late symptoms of withdrawal include:

Abdominal cramping

Diarrhea

Dilated pupils

Goose bumps

Nausea

Vomiting
Opioid withdrawal reactions are very uncomfortable but are not life threatening.
Symptoms usually start within 12 hours of last heroin usage and within 30 hours of last
methadone exposure.
Exams and Tests
Your doctor can often diagnose opiate withdrawal after performing a physical exam and
asking questions about your medical history and drug use.
Urine or blood tests to screen for drugs can confirm opiate use.
Treatment
Treatment involves supportive care and medications. The most commonly used
medication, clonidine, primarily reduces anxiety, agitation, muscle aches, sweating,
runny nose and cramping.
Other medications are used to treat vomiting and diarrhea.
Buprenorphine (Suptex) has been shown to work better than other medications for
treating withdrawal from opiates, and can shorten the length of detox. It may also be used
for long-term maintenance like methadone.
People withdrawing from methadone may be placed on long-term maintenance. This
involves slowly decreasing the dosage of methadone over time. This helps reduce the
intensity of withdrawal symptoms.
Some drug treatment programs have widely advertised treatments for opiate withdrawal
called detox under anesthesia or rapid opiate detox. Such programs involve placing you
under anesthesia and injecting large doses of opiate-blocking drugs, with hopes that this
will speed up the return to normal opioid system function.
There is no evidence that these programs actually reduce the time spent in withdrawal. In
some cases, they may reduce the intensity of symptoms. However, there have been
several deaths associated with the procedures, particularly when it is done outside a
hospital.
What is Morphine
Generic Name: morphine (MOR feen)
Brand names: Avinza, Kadian, MS Contin, MSIR, Oramorph SR, Roxanol
Street names
STREET TERMss
DEFINITION
C&M
Cocaine and morphine
Cotton brothers
Cocaine, Heroin and morphine
Dreamer
Morphine
Emsel
Morphine
First line
Morphine
God's drug
Morphine
Hows
Morphine
M
Marijuana; morphine
M.S.
Morphine
Miss Emma
Morphine
Mister blue
Morphine
Morf
Morphine
Morpho
Morophine
New Jack Swing
Heroin and morphine
Unkie
Morphine
Morphine is in a group of drugs called narcotic pain relievers.
Morphine belongs to a group of drugs known as opiates. Morphine is derived from raw
opium from the poppy plant. Morphine is a painkilling drug and is one of the most
effective drugs known for pain relief so is mostly used to treat moderate to severe pain
and severe coughs. Morphine can also be used to ease pain before, during and after
operations.
What does morphine look like? Morphine can usually be found in tablet form, a syrup,
and injection or as a suppository form. Morphine is usually taken orally via a syrup,
tablet or capsule; however, it can come in an injectable form.
What are the immediate effects of taking morphine?
Morphine will provide relief from pain and gives the patient a sense of wellbeing.
Opiates in general slow down breathing, heart rate and brain activity and as a result the
body's tolerance to pain is increased. Morphine also suppresses the cough reflex which is
why it is used to treat severe coughs. Morphine does have side-effects, two of the most
common are constipation and nausea and with higher doses of morphine, additional drugs
to relieve or prevent these symptoms may be needed.
What are the long-term effects of taking morphine?
When morphine is prescribed by a doctor for the treatment of pain and is taken in the
prescribed dosage, they are safe and there is little chance of addiction. However, when
morphine is not used for medical uses and is abused by being taken in excessive doses,
addiction can result and so you should never stop taking it suddenly. If you stop taking
the drug suddenly withdrawal symptoms can occur. The severity of the symptoms will
depend on the amount of drug taken and for how long. Withdrawal symptoms may
include uneasiness, diarrhea, abdominal cramps, nausea, chills and insomnia.
Morphine is used to treat moderate to severe pain. It works by dulling the pain perception
center in the brain. Short-acting formulations are taken as needed for pain. Extendedrelease formulations are used when around-the-clock pain relief is needed.
Morphine may be habit-forming and should be used only by the person it was prescribed
for. This medicine should never be given to another person, especially someone who has
a history of drug abuse or addiction. Keep the medication in a secure place where others
cannot get to it.
Do not drink alcohol while you are using morphine. Dangerous side effects or death can
occur when alcohol is combined with morphine. Check your food and medicine labels to
be sure these products do not contain alcohol.
Never take more than your prescribed dose of morphine. Tell your doctor if the medicine
seems to stop working as well in relieving your pain.
Do not stop taking morphine suddenly, or you could have unpleasant withdrawal
symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping
the medication.
Before using morphine, tell your doctor if you are allergic to any drugs, or if you have:

asthma, COPD, sleep apnea, or other breathing disorders;

liver or kidney disease;

underactive thyroid;

curvature of the spine;

a history of head injury or brain tumor;

epilepsy or other seizure disorder;

low blood pressure;

gallbladder disease;

Addison's disease or other adrenal gland disorders;

enlarged prostate, urination problems;

mental illness; or

a history of drug or alcohol addiction.
How does morphine affect the body?
Morphine, a narcotic, acts directly on the central nervous system. Morphine can;

Relieve pain

Impair mental and physical performance

Relieve fear and anxiety

Produce euphoria
It also can;

Decrease hunger

Inhibit the cough reflex

Produce constipation

Usually reduces the sex drive

In women it may interfere with the menstrual cycle
FDA pregnancy category C. Morphine may be harmful to an unborn baby, and could
cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are
pregnant or plan to become pregnant during treatment. Morphine can pass into breast
milk and may harm a nursing baby. Do not use this medication without telling your
doctor if you are breast-feeding a baby.
Usual Adult Dose for Pain
Oral, Sublingual, or Buccal: 5 to 30 mg every 3 to 4 hours as needed
Extended release: range from 10 mg to 600 mg daily, given in equally divided doses
every 8 to 12 hours or given as one dose every 24 hours
IM or subcutaneous: 2.5 to 20 mg every 3 to 4 hours as needed
IV: 4 to 15 mg every 3 to 4 hours as needed. Give very slowly over 4 to 5 minutes.
Starting doses up to 15 mg every 4 hours have been used. Chest pain: 2 to 4 mg repeat as
necessary
Continuous IV: 0.8 to 10 mg/hour. Maintenance dose: 0.8 to 80 mg/hour. Rates up to 440
mg/hour have been used.
IV patient controlled analgesia or subcutaneous patient controlled analgesia: 1 to 2 mg
injected 30 minutes after a standard IV dose of 5 to 20 mg. The lockout period is 6 to 15
minutes. The 4 hour limit is 30 mg.
Continuous subcutaneous: 1 mg/hour after a standard dose of 5 to 20 mg
Epidural: 5 mg one time. May give 1 to 2 mg more after one hour to a maximum of 10
mg.
Intrathecal: 0.2 to 1 mg one time
Intrathecal Continuous: 0.2 mg/24 hours. May be increased up to 20 mg/24 hours.
Intracerebroventricular: 0.25 mg via an Ommaya reservoir.
Rectal: 10 to 30 mg every 4 hours as needed.
Reference
http://www.drugs.com/morphine.html
http://www.homehealth-uk.com/medical/professional_drugtests_morphine.htm
http://www.americanhospice.org/articles-mainmenu-8/caregiving-mainmenu-10/233-useof-opiates-to-manage-pain-in-the-seriously-and-terminally-ill-patient
http://www.soberrecovery.com/articles/85.html
http://morphinefacts.com/