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Morphine Addiction

Posted on January 30, 2013 in Prescription Drug Addiction

Morphine AddictionBefore OxyContin, Vicodin, and Percocet – there was morphine, the granddaddy of addictions. Before millions of today’s Americans became addicted to prescription drugs, other generations suffered from Soldier’s Disease and patent drug addictions based on morphine, the drug that fathered 90% of the opioid painkillers.

Many people do not understand the relationship between opium, morphine, heroin, laudanum and all the various opiate/narcotic painkillers on the market today. These drugs are all more alike than they are different. They all have similar chemical structures, and they all produce pain relief, cough suppression, and addiction.

Opium dates to prehistoric times, and comes from the sap of seed pods of poppy plants. Opium can be made in a primitive, low-tech way, and is a completely natural product made only from poppies.

Morphine was discovered in 1807 by Wilhelm Serturner, whose wife became the first morphine addict. Like opium, morphine is made from the dried milk of poppy seed plants and is 100% natural. The great advantage of morphine to humanity was that it could provide a more predictable form of pain relief than opium. Once hypodermic needles were invented, morphine could be used on battlegrounds to relieve wounded soldiers’ pain and ease dying soldiers into painless deaths. Sadly, over 400,000 Civil War troops came home with morphine addictions or what they called “soldier’s disease.”

Laudanum is a herbal remedy that is mostly alcohol and 1% morphine. Tens of thousands of Americans became addicted to patent medicines containing laudanum between 1870 and 1914, the year the first federal drug regulations appeared.

Heroin is “extreme morphine.” You make it by adding two acetic acids to morphine, so it is both a natural and synthetic drug. Its effects on the human body are identical to morphine; in fact, the body converts heroin into morphine. As Dr. Andrew Weil wrote, “In reality, heroin is not much different than morphine.”

Some opioid painkillers like codeine are also made from morphine and man-made chemicals. Others are entirely man-made but chemically related to morphine.

Until the 1970s or so, doctors in the United States rarely prescribed morphine, perhaps because they were closer to the experience of other generations who had become addicted to it. The hospice movement changed all that as morphine returned as an aid to palliative care for the dying. Today as doctors more frequently prescribe morphine and its cousins, a new generation is discovering just how addictive these drugs are.

What Is Morphine?

The chemical name for morphine is: (5 alpha, 6 alpha) 7,8 didehydro-4,5poxy-17methylmorphinan-3,5diol.

Legally, morphine is classified as a Schedule II Controlled Substance, which means it has some medical uses but is highly regulated by the U.S. government as a highly addictive drug.

Morphine is available by prescription only as capsules, tablets, or liquid. Terminally ill or unconscious patients can be put on “morphine drips” to allow the drug to enter their bodies through tubes rather than by swallowing it. Liquid morphine is also taken by dropper or spoon. Trade names for liquid morphine are Duramorph, Roxanol and Rescudose. Two extended-release versions of morphine are available — Kadian is the trade name of a capsule taken every 12 hours; Avinza capsules are taken every 24 hours. Oramorph SR, Roxanol, MSIR and MS Contin are pills, and some can be taken every four hours.

What Are The Medical Uses Of Morphine?

Its main use is to relieve pain from cancer. It is not supposed to be prescribed for mild, acute, post-operative pain or pain that only lasts a few days. It is not prescribed on an “as needed” basis.

Scientists are experimenting with using morphine for children’s pain because some new studies indicate that it may be safer than codeine. Morphine has an extremely calming effect on most people, which may be why it could potentially prevent post-traumatic stress syndrome. A study of Iraqi veterans published in the New England Journal of Medicine found that the incidence was PTTS was cut in half among those who received morphine when they were wounded.

Side Effects Of Morphine

The manufacturer of Avinza, a commonly sold version of morphine, lists “death” as a common serious adverse event associated with using its product. Others listed are vomiting, nausea, dehydration, shortness of breath, and sepsis (blood poisoning).

Common and less serious side effects are constipation, nausea, sleepiness, vomiting, and headaches. Less common are urinary tract infections, abdominal pain, flu symptoms, back pain, rashes, sweating, fevers, insomnia, depression, loss of appetite, dry mouth, and weakness. Morphine slows the body down, so people will have decreased rates of breathing, heart beating, and digestion. Some people experience effects on their nervous systems such as weird dreams, abnormal thinking, vertigo, amnesia, anxiety, confusion, convulsions, and problems with muscle coordination. You can take drugs that minimize the side effects of morphine.

Morphine is not approved for pregnant or nursing women or children. It caused abnormalities in the offspring of animals whose mothers were given it. It should not be taken by people with breathing diseases, seizures, mental illnesses, histories of drug addiction or alcoholism, brain tumors, head injuries, low blood pressure, Addison’s disease, or diseases of the kidney, liver, pancreas, or gallbladder.

Some people become physically dependent on morphine or other narcotic painkillers after using them for pain. These people have withdrawal symptoms when they stop using their drugs, but they are not addicted in the sense they do not have drug cravings and drug-seeking behaviors once they stop using. Doctors can often simply wean these patients slowly off morphine. Non-pharmaceutical ways of managing pain, such as yoga, relaxation and massage, can be helpful sometimes.

Drug Interactions And Morphine

It is dangerous to use alcohol with morphine, because alcohol causes rapid release of the drug. A dosage meant to last 24-hours can be absorbed all at once. Morphine should not be used with anything that has alcohol in it, even cough medicines, cold remedies or mouth washes.

Morphine interacts with any drug that slows the central nervous system. If you mix morphine with these drugs, you could stop breathing and die. These are sleeping pills, anti-depressants, muscle relaxants, tranquilizers, sedatives, barbiturates, other narcotic painkillers, beta blockers, and drugs for mental illnesses. Other reactions occur if morphine is mixed with blood thinners, diuretics, seizure medications, buprenorphine, anti-histamines, MAO inhibitors, and drugs for chronic lung diseases like asthma and bronchitis.

Dangers of Morphine

The three greatest dangers are having an allergic reaction the first time you use it that results in your death, the second is addiction, and the third is death by overdose.

Doctors have no way of knowing if people who have never taken narcotics are allergic to them, and allergic reactions can cause death. The person may have hives, shortness of breath, rashes, confusion, hallucinations, dizziness, trouble or even stoppage of breathing, chest pain, swelling of face and hands, and seizures. At this point he must get medical attention. Typically doctors start a morphine dosage very slowly to test for such a reaction, but people who abuse drugs often die this way because they do not know better.

Morphine Overdoses

The person who overdoses on morphine is often an addict who has built up a tolerance to the drug and needs more to get the same effects, and then accidentally takes too much. Other overdoses are usually linked to taking morphine with alcohol, opioids, or central nervous system depressants.

Symptoms of overdose are slow breathing, sleepiness, small pupils, slow heart beat, fainting, limp muscles, nausea, bloody urine, blurred vision, cold skin, fainting or loss of consciousness.

At an emergency medical facility, doctors will administer an opioid antidote, usually naloxone or nalmefene, insert breathing tubes, and use vasopressors. The person may need to go on life support if she went into cardiac arrest, and be monitored until she can breathe on her own.

Withdrawal from Morphine

Some symptoms can be similar to flu, including backache, joint and muscle pain, weakness, abdominal cramps, vomiting, diarrhea, tearing eyes, stuffy nose, sweating, and chills. Other characteristics of the withdrawal syndrome can be pinpoint pupils, insomnia, irritability, and increases in blood pressure, breathing and heart rate. This syndrome is very unpleasant and the most common question asked is, “How long will this last?”

The severity of the syndrome and how long it lasts depend on individual factors such as the amounts of morphine used and in what amounts, the age, gender and general health of the person, and so forth. Twelve hours or so after you take the last dose of morphine, the syndrome will begin, and you may have mood changes like restlessness, anxiety and drug cravings. About twelve hours after that, you may develop the full syndrome of shaking legs, nausea, high blood pressure, cramps, etc. This can last two to three days and become so bad that you lay in a fetal position – sweating, vomiting, and completely ill. It should disappear in seven to ten days. It can be dangerous to try detoxification on your own because of the possibility developing seizures and psychotic symptoms like hallucinations.

If you enter a treatment facility where doctors can monitor you during morphine withdrawal, they can ease your symptoms with various drugs and other techniques. Anti-anxiety drugs, muscle relaxants, anti-psychotics, high blood pressure drugs, and even certain opioids like methadone are often administered.

Signs You Are Addicted To Morphine

If you can answer yes to any of these questions, you should seek treatment for morphine addiction or dependency. Try asking your family physician or local mental health facility for advice.

  • Are you abusing morphine along with other drugs?
  • Do you need to use more morphine than you did in the past in order to achieve the effect you want?
  • Are you afraid you will eventually become addicted to heroin?
  • Do you worry when it is hard to obtain morphine or when you run out of it? Are you worried about legal consequences?
  • Do you feel guilty or ashamed about using morphine?
  • Is your use of morphine interfering with your performance at work or school?
  • Do you drive an automobile under the influence of morphine?
  • Do you experience withdrawal symptoms when you stop using morphine?
  • Do you tell yourself you will quit using morphine after this one last time?
  • Have you tried unsuccessfully to quit using morphine in the past?
  • Do you need to use drugs just to feel normal?
  • Do your family members or friends complain about your drug use?
  • Did you feel you are wasting precious time by being addicted to morphine?
  • Are you too embarrassed to talk to someone about your morphine addiction?

Morphine Addiction Treatment

Morphine addictions have increased in the past few decades because the number of morphine prescriptions tripled since 1990.

Heroin and morphine addicts have the highest rates of relapse because their drugs are so addictive. It is possible to become addicted to them within a few days. One study from the University of Oregon found that rats will keep hitting buttons to get more morphine and then stop eating until they starve themselves to death.

Morphine attaches itself to receptor cells in the brain and spinal column – cells that are meant to receive chemicals that the human body produces naturally to control pain and experience pleasure. Morphine addiction can chemically alter the natural function of experiencing pleasure, and lead to a state of permanent depression.

Morphine addicts typically crush, chew or snort the extended-release pills or capsules in order to achieve immediate release of dose meant to last 24-hours. They also use home laboratories to “home-bake” morphine into heroin, and then usually smoke it or “chase the dragon.” Street names for morphine are Miss Emma, M, Morph, morphy, murphy, cube, monkey, dream, white stuff, and white lady.

Some morphine addicts can successfully complete chemical withdrawal from the drug on their own, only to become overwhelmed by psychological symptoms such as depression, drug cravings, low self-esteem, insomnia, confusion and mood swings. They may feelings of worthlessness when they think about the “lost years” of addiction. They may have trouble coping with everyday stress without using drugs and become overwhelmed with feelings of nervousness and anxiety. The majority of addicts talk and think about morphine for months after they actually quit using it.

Morphine addiction recovery can be a long process, and you have the greatest chance of success if you get professional help. If you enter a residential treatment center, you have an even better chance of permanent recovery because your program is intense and 24/7. You live away from your old drug environment where certain people, places and situations trigger relapses.

Typical treatment is multi-disciplinary and may include intensive counseling, training in physical fitness and nutrition, classes in managing drug cravings and triggers, journaling, art, music, drama, yoga, and 12-step programs.

The majority of morphine addicts have underlying psychological problems that “travel” with and contribute to their drug abuse. The most common are depression, unresolved childhood trauma, low self-esteem, and anxiety disorders. These are treated as separate conditions with separate protocols and medications.

Most morphine addicts remain in support groups for at least a year after they quit using drugs.

Sources:

Lee, Edward. “Happy Birthday, Morphine,” The National Review of Medicine, July 30, 2005,  Volume 2 No. 13

“Morphine,” Encyclopedia Britannica, Chicago: Encyclopedia Britannica, Inc., 2005, Volume 8, Page 334.

Morphine Facts, The National Institute of Drug Abuse, posted at http://www.drugabuse.gov/pubs/teaching/Teaching2/Teaching4.html

Weil, Dr. Andrew. From Chocolate to Morphine. (New York: Howard Mifflin), 1998, pg. 83-85.

Ibid.

“Avinza,” Information for consumers from manufacturer, see http://www.avinza.com/

Morphine (Oral), The U.S. Library of Medicine, PubMed Health, see http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000590/

“Morphine,” The United States Drug Enforcement Agency website at http://www.usdoj.gov/dea/concern/morphine.html

“Avinza® Roxanol® etc” at RX-List, see http://www.rxlist.com/cgi/generic/morph_ids.htm

“Avinza,” The RX List, see http://www.rxlist.com/avinza-drug/indications-dosage.htm

Rabin, Roni. “Hazards: Codeine’s Safety Is Questioned,” The New York Times, October 11, 2010

Carey, Benedict. “Morphine May Help Traumatic Stress,” The New York Times, January 14, 2010.

“Avinza,” Information for consumers from manufacturer, see http://www.avinza.com/

“Avinza,” Information for consumers from manufacturer, see http://www.avinza.com/

Ibid.

Ibid.

“Morphine (Oral Route),” The Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603253/

Ibid, see also “Avinza,” Information for consumers from manufacturer, see http://www.avinza.com/

“Morphine Information,” Drugs.com posted at http://www.drugs.com/morphine.html

Morphine (Oral), The U.S. Library of Medicine, PubMed Health, see Avinza, The RX List, see http://www.rxlist.com/avinza-drug/indications-dosage.htm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000590/, and also

Ibid.

“Avinza,” Information for consumers from manufacturer, see http://www.avinza.com/

“Opioid Withdrawal Medications,” see http://www.drugs.com/condition/opiate-withdrawal.html

“Morphine,” The United States Drug Enforcement Agency website at http://www.usdoj.gov/dea/concern/morphine.html

O’Neal, Mary. J. Merck Index: Encyclopedia of Drugs, Chemicals and Biologicals, October 18, 2006.

Beck, Sheryl and James O’Brien. “Lethal Self-Administration of Morphine by Rats,” Physiology & Behavior, Volume 25, Issue 4, October 1980, Pages 559-564.

“Morphine Information,” Drugs.com posted at http://www.drugs.com/morphine.html

“Morphine,” The United States Drug Enforcement Agency website at http://www.usdoj.gov/dea/concern/morphine.html

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