Morphine: Abuse, Addiction & Treatment


Morphine is a prescription opioid widely administered in both generic formulations and branded products such as Kadian and MS Contin.1

Morphine is a very effective painkiller, but it does have a high potential for abuse and should only be used as directed.2

What Is Morphine Made of?

A naturally occurring plant alkaloid, morphine is sourced from the opium poppy. Opiate substances like morphine have historically been used to manage pain and, in some instances, suppress cough or treat diarrhea.1,2

Forms of Morphine

Morphine is available in several forms including:

  • Tablets (both immediate- and extended-release).
  • Oral solutions.
  • Injectable solutions.

Is Morphine Addictive?

Morphine prescription

Yes. Like any opioid, morphine is associated with a dose-dependent euphoric high in addition to its therapeutic pain relief, which may lead people to misuse it. Continued abuse of morphine may lead to the development of an opioid use disorder, or addiction.1

Morphine misuse/abuse can take many forms, including:1

  • Using morphine at higher doses, more frequently, or for durations of time that exceed prescribed limits.
  • Using the medication in ways other than directed, e.g., crushing and snorting the tablets.
  • Taking someone else’s morphine prescription.
  • Taking morphine for the euphoric high.

Morphine’s Short-Term Effects

Morphine’ pleasant short-term effects include:1

  • Euphoria/happy feelings.
  • Pain relief.
  • Relaxation.

However, not all of the effects of morphine are desirable. Side effects of this medication may include:3

  • Drowsiness.
  • Nervousness.
  • Mood swings.
  • Small pupils.
  • Dry mouth.
  • Headache.
  • Constipation.
  • Decreased sexual desire.
  • Changes in a woman’s menstrual cycle.

The side effects are often manageable when the drug is used as directed, but when the drug is abused or taken in excess, they may intensify. In overdose, morphine can be very dangerous and may result in death.

Morphine Overdose Symptoms

Overdose occurs when a person takes too much morphine, either on purpose or by accident. Symptoms of overdose include:4,5

  • Nausea.
  • Vomiting.
  • Tiny/pinpoint pupils.
  • Muscle weakness.
  • Extreme sleepiness.
  • Profound confusion.
  • Slowed heart rate.
  • Low blood pressure.
  • Cold and/or clammy skin.
  • Slow, shallow, labored, or stopped breathing.
  • Blue-tinted skin around the mouth and fingertips.
  • Coma.
  • Death.

Morphine overdose can cause severe respiratory depression, so immediate treatment is absolutely essential. Extended time periods without oxygen can result in serious brain injury or death.1 Naloxone (Narcan) can reverse an opioid overdose, but immediate treatment in a hospital may still be required even if naloxone is administered. Always call 911 immediately for help if you suspect someone has overdosed on morphine.1,5

Overdose may be more likely in the case of polysubstance use involving alcohol and other central nervous system depressants.4

Morphine and CNS Depressants: A Deadly Combo

Pills and alcohol

Morphine and other opioids can dangerously increase the effects of central nervous system depressants, including alcohol and sedatives (e.g., benzodiazepines).4 Effects such as respiratory depression, slowed heart rate, and reduced blood pressure, for example, may all be compounded to a very dangerous degree, and the result can be deadly.4  The involvement of benzodiazepines and alcohol in opioid overdose deaths highlights this danger. In 2017, just over 20% of opioid overdose deaths involved benzodiazepines.6  That number rose to more than 33% when looking only at overdose deaths from prescription opioids like morphine.6  The same year, alcohol was involved in nearly 15% of all opioid overdose deaths.6  Unfortunately, recreational opioid users often abuse alcohol and other CNS depressants in combination with their opioid of choice.6  

Long-Term Risks of Morphine Abuse

Misusing morphine or any other opioid medication over a long period may result in:7,8,9

  • Chronic constipation and bowel obstruction.
  • Decreased fertility in women.
  • Neonatal abstinence syndrome.
  • Endocrine problems leading to issues such as loss of libido, anxiety, fatigue, and depression.
  • Cognitive problems, such as memory impairments.
  • Increased risks of falls and fractures in the elderly.
  • Increased sensitivity to pain.
  • Growing tolerance.
  • Physical dependence on the drug.
  • Opioid use disorder (addiction).
  • Overdose.
  • Death.

Morphine Dependence and Withdrawal

It can take very little time to become physically dependent on opioids, and the associated withdrawal syndrome can be extremely uncomfortable. Avoidance of opioid withdrawal can keep some people using morphine despite a desire to quit.1,10

Morphine Withdrawal Symptoms

Morphine withdrawal symptoms may include:10

  • Low mood/feeling of unease.
  • Irritability.
  • Insomnia.
  • Restlessness.
  • Increased pain sensitivity.
  • Excessive yawning.
  • Runny nose.
  • Teary eyes.
  • Fever.
  • Sweating.
  • Goosebumps.
  • Dilated pupils.
  • Muscle aches.
  • Diarrhea.
  • Nausea.
  • Vomiting.

Some degree of physical dependence may develop even with regular prescription use of an opioid and does not necessarily indicate that a person is misusing or addicted to morphine. While it is one potential sign of an opioid use disorder, it is certainly not the only one.10

Signs of an Opioid Use Disorder

Addiction to opioids may involve the continued, compulsive use of one or more opioids despite the knowledge that doing so is causing major problems with one’s health, relationships, or other areas of their life.10

Some signs of morphine addiction—or an opioid use disorder involving morphine—include:10

  • Having tried and failed to quit using morphine.
  • Taking more morphine or taking it for longer than you meant to.
  • Expending a lot of time and effort in getting, using, and recovering from morphine.
  • Compulsively using morphine even when it causes or worsens health problems (physical or psychological), creates relationship conflicts, or interferes with your professional or domestic obligations.
  • Using morphine before engaging in activities where being intoxicated by it could be hazardous (e.g., operating machinery or driving a car).
  • Craving morphine.

If you’re unable to quit using an opioid even though it is causing distress in your life, you may need professional addiction treatment.

Morphine Addiction Treatment

Meeting in rehab

Opioid addiction treatment can take place in either an inpatient or outpatient environment; however, many people prefer to begin their recovery in an inpatient rehab that includes medical detox, because the withdrawal syndrome from opioids can be extremely uncomfortable and may, in some cases, be accompanied by dangerous complications such as dehydration or electrolyte imbalance. Those with underlying medical conditions, such as cardiac problems, may also be at increased risk during withdrawal and require the support of a 24/7 medically monitored detox environment.11

Withdrawal management (detox) is only the first step in the process. Detox should be followed by further therapeutic treatment, where you can learn to understand the root causes of your substance abuse, address problematic behaviors, and learn the coping skills and other tools to maintain your sobriety.12

Whether you prefer to get this care in a residential program or in an outpatient program, we have what you’re looking for. Recovery First’s offerings include but are not limited to medical detox, inpatient/residential programs, and intensive outpatient therapy. We invite you to call us at 954-526-5776 at any time to speak to a caring admissions navigator about what you’re looking for and how we can help. We’re here for you 24/7 to help you take your first step on the road to recovery.

References

  1. National Institute on Drug Abuse. (2020). What are prescription opioids?
  2. U.S. Drug Enforcement Administration. (2017). Drugs of Abuse: A DEA Resource Guide.
  3. U.S. National Library of Medicine. (2019). Morphine.
  4. U.S. National Library of Medicine. (n.d.). MORPHINE SULFATE tablet.
  5. U.S. National Library of Medicine. (2018). Morphine Overdose.
  6. Na Tori ME, Larochelle MR, Naimi TS. Alcohol or Benzodiazepine Co-involvement With Opioid Overdose Deaths in the United States, 1999-2017JAMA Netw Open.2020;3(4):e202361.
  7. Sizar O, Genova R, Gupta M. Opioid Induced Constipation. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
  8. Darnall, B. D., Stacey, B. R., & Chou, R. (2012). Medical and psychological risks and consequences of long-term opioid therapy in women. Pain medicine (Malden, Mass.)13(9), 1181–1211.
  9. Teater, D. (n.d.). The Psychological and Physical Side Effects of Pain Medications.
  10. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  11. Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.
  12. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.

 

 



About The Contributor

Scot Thomas, M.D.
Scot Thomas, M.D.

Senior Medical Editor, American Addiction Centers

Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating... Read More


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