Morphine Addiction and Abuse

Morphine is an opiate painkiller generally used to treat moderate to severe chronic pains. Derived from the Greek god Morpheus (god of dreams), the drug causes a euphoric dreamlike state when consumed. Morphine is a natural opiate obtained from the concentrated opium poppy plant similar to that of heroin. . Morphine is a Schedule II drug that comes in the form of injection, tablet, capsules, and syrup in the US. It is the preferred choice of painkiller in cases such as post-surgery pain maintenance, managing cancer-related pains, and helping ease patient’s during their end of life. This drug can be consumed orally, intravenously, or nasally. Other brand names of morphine may include Zomorph, Oramorph, MST, MXL, Sevredol, and Morphgesic.

Fast-acting morphine consumed orally generally takes 30 – 60 minutes to activate compared to when taken intravenously, which can be instant. However, short-acting morphine takes a day or two to activate but tends to last much longer.

Morphine is a CNS depressant that blocks pain signals from the brain, reaching the rest of the body while also reducing anxiety and stress in the user. Morphine is a highly abused drug due to its capacity to relieve suffering from those with severe chronic pains. Morphine is a narcotic drug with a high potential to cause tolerance within a short period, leading to a drastic increase in the drug’s capacity to cause dependence, abuse, and addiction among users. Although many abuse the drug for its intense pain relief, they are also abused for their dreamlike euphoria.

Signs of morphine abuse may include:

• Nodding off
• Inattention
• Shallow breathing
• Legal issues
• Slurred speech
• Doctor shopping
• Neglecting daily responsibilities
• Isolation from loved ones
• Mood swings
• Irritability
• Dilated pupils

In recent years, morphine pills manufacturers began to add abuse-deterrent coding to prevent the pills from being crushed, snorted, and injected. Although this has decreased the addictive capacity of prescription morphine, it did not eliminate its potential impact on illicitly produced morphine. Street names of morphine may include Miss Emma, M, White Stuff, Roxanol, and Monkey.

Common effects of morphine include:

• Pain relief
• Reduced anxiety
• False or unusual sense of wellbeing
• Sleepiness or unusual drowsiness
• A relaxed or calm feeling
• Euphoria

Consumption of morphine without a prescription is considered abuse. Although morphine is a legal prescription medication, its highly regulated nature makes possession of morphine without a prescription a criminal offense.

Prolonged use of morphine in high doses can cause addiction. During this stage, patients may experience distressing withdrawal symptoms when trying to quit or reduce drug consumption. Patients are highly advised to seek medical help if they wish to stop using it after consuming the drug for a few weeks. As psychological dependence on this drug develops soon after physical dependence, abrupt cessation of morphine can cause adverse and intense symptoms. Misusing morphine in higher doses due to the build-up of tolerance can lead to an overdose that can be fatal.

Morphine overdose comes with a list of life-threatening health complications, including:

• Fever
• Elevated blood pressure
• Decrease in responsiveness
• Swelling of the face and extremities
• Muscle spasms, cramps, and stiffness
• Increased thirst
• Lower back or side pain
• Slowed respiratory function
• Coma

Morphine’s capability to cause tolerance within a short period makes overdose its greatest danger. As a patient consumes more and more of the drug to achieve the effects, they desire this powerful central nervous system depressant can drastically slow down the users breathing to the point of respiratory failure, coma, or even death. The short-term impacts of this drug can vary depending on the usage and the amount consumed.

Some possible immediate side effects of morphine use include:

• Slowed breathing
• Apathy
• Nausea
• Severe respiratory depression
• Coma
• Inability to concentrate
• Dizziness
• Nervousness
• Itchy skin
• Chest pain
• Hallucinations
• Decreased sexual drive/performance
• Rapid heartbeats
• A false sense of wellbeing
• Dry mouth
• A relaxed and calm feeling
• Sleepiness
• Mood changes
• Euphoria
• Drowsiness

Long-term use of morphine can result in many adverse side effects, including addiction.

Other long-term side effects of morphine use include:

• Suppressed immune system
• Restlessness
• Depression
• Severe constipation
• Collapsed veins
• Confusion
• Mood disorders

Over half of accidental drug-related deaths in the country were a result of morphine and heroin use. Other statistics related to morphine use in the US are:

• 10 Percent: About 10% of the country’s population has misused an opiate medication in their lifetime.
• 106 Percent: The number of morphine-related SUD patients admitted to the ER rose by 106% between 2004 to 2008.
• 60 Percent: More than 60% of morphine users obtained the drug from friends and relatives.

Recognizing an addiction to morphine can be tricky due to it being considered a prescription medication. Although morphine is an essential medication for those who are suffering from severe chronic pain, it is, however, a drug that can be easily abused.

Medical experts make use of 11 criteria when determining the level of addiction in morphine users. Depending on the overall score, the doctor can determine the severity of the addiction.

The symptoms of morphine addiction may include:

• Wanting to limit the intake of morphine, but unable to do so.
• Spending a tremendous amount of time, money, and effort on, getting, misusing, and recovering from morphine.
• Intense cravings for morphine consumption.
• Neglecting obligations and responsibilities at work and at home.
• Frequently isolating oneself from family and acquaintances.
• Placing themselves and others in dangerous situations to obtain or use morphine.
• Experiencing withdrawal symptoms when they try to limit or avoid taking morphine.

Combining morphine with other CNS depressants can be highly dangerous. This form of abuse is referred to as polydrug abuse. Combining morphine with CNS depressants such as alcohol and benzos can cause severe sedation, respiratory depression, or even coma. Although morphine can be consumed alongside paracetamol, aspirin, or ibuprofen, it is never a good idea to consume codeine or codeine-containing painkillers with prescription morphine.

Many who find themselves addicted to morphine fail to recognize their addiction and abuse. As the drug is seen as an essential aid in pain management, it is highly likely for a patient to not understand the severity of their predicament. During such situations staging an intervention can be an eye-opening moment for the user if the procedure is carried out correctly. Interventions are ideally the first step toward recovery as they provide the motivation the patient requires to seek help. When conducting an intervention, it is vital to seek help from a professional interventionist as they are usually far more equipped to handle such situations more effectively.

When an individual develops a dependence on morphine, their body becomes to rely on its effects to function on a day to day basis. The abrupt cessation of the drug can cause an imbalance in the body that can cause severe distress to the user. These symptoms are known as withdrawal. Since the brain requires a few days to readjust to the change of not having the drug in the system, quitting morphine cold turkey can shock its rewarding system. Withdrawal symptoms can generally manifest within 6 -12 hours after the last dose. Most of the withdrawal symptoms caused by morphine are flu-like symptoms that can cause psychological and physical distress on the user.

Morphine withdrawal can be distressing, especially for users with a severe addiction. The intensity of symptoms can vary, depending on the user, the dose, frequency of use, method of administration, polydrug abuse, and medical history.

Common morphine withdrawal symptoms include:

• Fever
• Vomiting
• Sweating
• Watery eyes
• Chills
• Diarrhea
• Rapid heartbeat
• Agitation
• Body aches and pains
• Muscle aches
• Irritability
• Increased blood pressure
• Disorientation
• Headaches
• Insomnia
• Depression
• Excessive sweating
• Runny nose

Though withdrawal symptoms caused by morphine aren’t potentially life-threatening, they can be quite intense. Due to their intensity, patients are highly advised to seek medical and professional treatment at a specialized treatment center to avoid relapses.

The duration of withdrawal may vary from one patient to another. However, withdrawal symptoms generally tend to occur within 6 -12 after the last dose.

Although physical flue like symptoms only lasts for 3 -5 days in a patient, post-acute withdrawal symptoms (PAWS) or psychological symptoms can last for weeks or months and can be the hardest to manage.

Long-term psychological withdrawal symptoms of morphine are:

• Depression
• Inability to experience pleasure
• Mood swings
• Anxiety
• Insomnia
• Poor concentration
• Decreased energy

According to the findings of Georgetown University Medical Center, abruptly stopping the consumption of morphine can lead to adverse conditions, such as inflammation and damage to healthy brain cells. For those reasons, a medically-assisted detox is highly recommended for those who seek to quit morphine. Medical detox generally takes place in a rehab center under medical supervision. Such procedures help lower the intensity of withdrawal symptoms to a greater extent.

However, patients with severe addiction may require the combination of the tapering method as well as medications to help alleviate their withdrawal symptoms during detoxification. During this process, patients may be prescribed medications such as suboxone, naltrexone, or methadone. Clonidine is also another drug choice for morphine detox. This medication can help patients manage withdrawal symptoms, such as sweating, anxiety, irritability, and cramping. Patients who require extra time to overcome their morphine addiction can use buprenorphine under medical supervision. It‘s a mild narcotic that binds with the same CNS receptors as morphine.

After the completion of detoxification, patients must undergo treatment at an inpatient rehabilitation center. Inpatient rehabs provide patients with a safe and secure environment void of all temptation and distractions. These live in rehabs allow patients to solely focus on their recovery while providing essential support and therapy required by the patient. Inpatient treatment is the most effective rehab option for morphine addiction. Such treatment plans generally last for about 90 days, depending on the severity of the addiction. Medically-assisted detox is the first step in inpatient treatment.

Though medical detox for morphine addiction only lasts for a few weeks, overcoming a morphine addiction is a lifelong process. It’s their commitment that keeps the patients on the right track in the long run. Continuing treatment with aftercare programs is essential in maintaining sobriety once the patient leaves the safety of inpatient rehab. These programs may consist of individual and group therapy, relapse prevention programs, and support groups. These programs are an essential part of addiction recovery.