Morphine is an opioid analgesic medication used in the treatment of acute or chronic pain that is moderate to severe. Morphine is a highly addictive substance, with a potential for abuse and dependence, and it can cause withdrawal symptoms when stopped. Due to these risks, morphine is a Schedule II controlled substance. [1]
- Morphine withdrawal symptoms include physical discomfort, emotional distress, and gastrointestinal issues, which can range from mild to severe.
- Withdrawal symptoms typically peak within the first few days after stopping morphine and can last for up to 10 days or longer in some cases.
- Professional treatment, including gradual tapering, medications, and detox support, can help safely manage morphine withdrawal symptoms.
Does morphine cause withdrawal symptoms?
It is common to experience withdrawal symptoms when stopping morphine use, especially if it has been used for a prolonged period and in large doses. Abruptly stopping morphine can also increase the risk of withdrawal symptoms, so a gradual dose reduction is recommended. Morphine withdrawal symptoms can range from mild to severe and may vary depending on the amount and duration of use. [2]
Tolerance and dependence can develop within days or weeks of morphine use, which can increase the risk of abuse and the occurrence of withdrawal symptoms. When tolerance develops, the effects of the substance become reduced, which can lead to an increase in usage or dosage and an increased risk of dependence. [1]
When dependence develops, the body becomes reliant on the substance. When the effects wear off, withdrawal symptoms occur, which can include physical and emotional effects. Physically dependent individuals may also experience withdrawal symptoms if an opioid antagonist, such as naloxone or naltrexone, is administered. [3]
Morphine withdrawal symptoms
Morphine withdrawal symptoms are common when abruptly stopping after prolonged use and can vary in severity. Common morphine withdrawal symptoms include: [1][2][3]
- Teary eyes
- Runny nose
- Yawning
- Sweating
- Chills
- Restlessness
- Aches and pains in muscles and joints
- Weakness
- Irritability
- Anxiety
- Low mood
- Insomnia
- Stomach pain and cramps
- Nausea
- Vomiting
- Diarrhea
- Increased blood pressure
- Increased heart rate
- Increased breathing rate
Typically, morphine withdrawal symptoms will not be life-threatening. However, in some cases, they can cause severe effects, such as dehydration caused by prolonged vomiting and diarrhea, which may lead to life-threatening complications. Similarly, mood and behavior changes may be severe in some cases and may cause suicidal ideation or severe anxiety symptoms. [4][5]
Severe withdrawal symptoms are more common in those who have abused morphine in large doses for several months or years. [1]
Morphine withdrawal timeline
Morphine withdrawal symptoms are likely to emerge within 12 hours of the last dose and will be at their most severe within the first few days. Severe symptoms may last for around seven to ten days and often will begin to alleviate after this time. [5]
However, some people may experience prolonged withdrawal symptoms, particularly following heavy use or abuse. In some cases, it can take several months before the effects of morphine withdrawal are completely alleviated. Some people may continue to experience anxiety, low mood, and pain for several months. [6]
Morphine cessation timeline
Reducing morphine use should be done gradually to help prevent withdrawal symptoms. This may vary from person to person and can depend on the amount and duration of their use and their individual needs. [1]
Typically, it is recommended to taper morphine slowly, with dose reductions every one to four weeks. The dosage can be reduced by around 10% or 10mg with each reduction, depending on the needs of the individual and the occurrence of withdrawal symptoms. [6]
It is recommended that a professional monitor the patient during the cessation process, who can advise about dose reductions and how to manage any withdrawal symptoms that occur. Cessation can be slowed or paused if necessary, to allow for withdrawal symptoms to be alleviated. [2]
Is morphine safe to withdraw from at home?
It may be safe to withdraw from morphine at home with the advice and monitoring of a medical professional. Someone who has used small doses of morphine for a short period may be less likely to experience withdrawal symptoms and may be safe to withdraw at home. [7]
However, heavy and prolonged usage is likely to cause more severe withdrawal symptoms that could require professional treatment. As such, individuals who have developed a significant physical dependence would be advised not to withdraw at home and should seek professional intervention to ensure their safety. [2][6]
If withdrawing from morphine at home alone or with professional intervention, individuals should ensure that they are hydrated and are aware of the potential dangers, so that professional support is utilized if required. [2]
Morphine detox treatment
People who are prescribed morphine will be likely to undergo regular treatment reviews with their prescribing doctor, who will advise on a safe and appropriate cessation. In most cases, medication will be gradually tapered, with monitoring and treatment of withdrawal symptoms. [1]
However, individuals who have been taking morphine for a long time or have been abusing the medication in large doses are likely to have developed a strong dependence and may require more extensive support in reducing and stopping use. This might require medically-assisted detox, which can be administered through inpatient or outpatient services. [7]
This will typically involve stopping morphine and replacing it with a longer-acting opioid agonist, such as methadone or buprenorphine. These medications work in a similar way to other opioids but cause less of a euphoric effect and can ease the detoxification process. [3]
Additional medications may be prescribed short-term during the detox process to help reduce withdrawal symptoms, such as: [2][3]
- Clonidine: to reduce sweating, high blood pressure, anxiety, and irritability
- Loperamide: to reduce diarrhea
- Benzodiazepines: to reduce anxiety, insomnia, and irritability
- Non-opioid pain relief: to manage physical pain
Methadone and buprenorphine can be prescribed short-term during withdrawal or long-term as a maintenance treatment to help prevent relapse. [7]
Additional treatments may be implemented during or following detox to help with the recovery process, including psychological and psychosocial intervention, holistic therapies, and group support. [2][6]
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