Morphine is an opioid analgesic medication, used to treat moderate to severe chronic or acute pain. Morphine is commonly prescribed for this purpose and is also abused for its euphoric effects. Morphine can cause several mild to moderate side effects, including constipation, nausea, sedation, drowsiness, and dizziness. It can also cause severe side effects and overdose, particularly if it is abused.
- Common side effects of morphine include nausea, dizziness, and sedation.
- Prolonged use increases the risk of dependence, addiction, and severe effects.
- Overdose can occur with misuse, requiring immediate medical attention.
What is morphine?
Morphine is an opioid analgesic medication that is only available by prescription. Because of the potential for abuse and dependence, morphine is a Schedule II controlled substance. [1]
Morphine is available as an oral liquid, tablet, capsule, and injectable solution. Immediate-release morphine is administered every four hours, while extended-release morphine is administered once every 12 or 24 hours. [2]
What is morphine used for?
Morphine is prescribed to treat moderate to severe pain that cannot be controlled by non-opioid pain relief. Morphine can be used short-term for acute pain or as a longer-term treatment for chronic pain. [1]
Why do people abuse morphine?
Morphine is a potent substance with a high potential for addiction, which can significantly increase the risk of its abuse. Individuals who are prescribed morphine for pain treatment may develop tolerance and dependence on the substance within several days or weeks, which can lead to substance abuse once the prescription is stopped. [1][2]
Tolerance is likely to develop with continued morphine use and can cause the effects of the medication to become reduced. This can lead to increased amounts taken or frequency of use to achieve desired effects, which may contribute to the risk of abuse. [3]
Once a physical dependence has developed, the body relies on the continued use of the substance. If use is stopped, unpleasant withdrawal symptoms are likely to emerge, which can cause the individual to misuse or abuse morphine to prevent these effects. [1]
Morphine blocks pain receptors and releases dopamine, which contributes to its analgesic and euphoric effects, reinforcing use and abuse. Morphine is often abused to achieve these effects by individuals with a prior prescription and those who have obtained the substance illicitly. [4]
Common side effects of morphine
Often, side effects of morphine are likely when starting a new treatment or when increasing the dosage. Generally, side effects will be relieved within a couple of weeks. However, persistent or concerning side effects should be reported to a doctor and may require treatment or a change of medication. [2]
Common side effects of morphine include: [1][2][3]
- Constipation
- Vomiting
- Nausea
- Stomach pain
- Sweating
- Sedation
- Drowsiness
- Lightheadedness
- Dizziness
- Dry mouth
- Flushing
- Headaches
- Reduced appetite
- Change in heart rate
- Confusion
- Skin rash or itching
- Euphoria
- Low mood
- Agitation
Severe side effects of morphine
Occasionally, morphine can cause severe side effects, particularly if it is used in large doses or abused. Severe side effects of morphine can include: [1][2][3]
- Trouble breathing
- Chest pain
- Fainting
- Swelling of the face or mouth
- Trouble swallowing
- Extreme drowsiness or dizziness
- Severe muscle stiffness
- Extreme change or irregularity in heart rate
- Fever
- Hallucinations
- Persistent vomiting or diarrhea
- Seizures
- Irregular menstruation
- Tolerance
- Dependence
- Addiction
Using morphine for a prolonged period, whether prescribed or illicit, can increase the risk of severe side effects and the development of tolerance, dependence, and addiction. [1]
Once physical dependence has developed, stopping the medication can lead to withdrawal symptoms, including restlessness, flu-like symptoms, anxiety, pain, and diarrhea. [1]
Addiction is more likely to occur following prolonged and heavy use or abuse of morphine and may occur alongside the development of tolerance and dependence. Addiction can cause detrimental effects on quality of life and well-being and may lead to harmful and dangerous behaviors. [1]
Morphine overdose
People using morphine may be at risk of accidental or intentional overdose, particularly if large doses or dangerous administration methods are used. Similarly, the risk of overdose is higher if morphine is used in combination with other central nervous system depressants, such as other opioids, alcohol, or benzodiazepines, which can lead to severe sedation, coma, respiratory depression, or death. [1]
Signs of morphine overdose include: [1][2]
- Pinpoint pupils
- Decreased heart rate and breathing rate
- Trouble breathing
- Cold and clammy skin
- Weakness
- Extreme sedation
- Heart attack
- Loss of consciousness
In the event of a morphine overdose, call 911 immediately. Life-saving treatment may be required. This can include the administration of Naloxone, an opioid antagonist, which blocks the effects of morphine. [2]
Getting treatment for morphine dependence
Individuals who are prescribed morphine will be likely to receive regular medication reviews with their prescribing doctor, who will advise on and initiate a safe cessation process. This will involve gradually reducing the dose of morphine to prevent withdrawal symptoms in those who have developed a dependence. [1]
Some people may require more extensive treatment to reduce or stop morphine use, particularly if a strong physical dependence and addiction have developed. This might involve detoxification and rehabilitation services, which can be provided in outpatient or inpatient facilities alongside additional interventions. [5]
Medications often used to treat morphine dependence include: [5][6]
- Opioid agonists: Buprenorphine and methadone are used to treat opioid use disorders (OUD) including morphine dependence. They can help reduce withdrawal symptoms and cravings during detox and can be used as long-term maintenance treatments to help prevent relapse.
- Opioid antagonists: Naltrexone can be used as a long-term treatment for OUD, although it should only be commenced 7-10 days after the last dose of morphine. Naltrexone blocks the effects of opioids and can help maintain abstinence.
- Symptom management: Various medications can be prescribed short-term to help manage withdrawal symptoms that can occur, including insomnia, diarrhea, vomiting, pain, flu-like symptoms, shaking, and increased heart rate. This includes clonidine, benzodiazepines, and non-opioid pain relief.
Individuals being treated for morphine dependence are also likely to benefit from various other interventions, to help manage their mental and physical well-being. This can include psychotherapies such as cognitive behavioral therapy (CBT), psychosocial interventions, holistic therapies, and group therapies. [5][6]
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