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What is Morphine?

Morphine is an extremely potent opiate analgesic psychoactive drug and is considered to be the prototypical opioid. In clinical medicine, morphine is regarded as the gold standard, or benchmark, of analgesics used to relieve severe or agonizing pain and suffering. Like other opioids, e.g. oxycodone (OxyContin, Percocet, Percodan), hydromorphone (Dilaudid, Palladone), and diacetylmorphine (heroin), morphine acts directly on the central nervous system (CNS) to relieve pain. Morphine has a high potential for addiction; tolerance and both physical and psychological dependence develop rapidly.

Indications:
  • Pain relief or analgesia
  • Cough suppressance
  • Antidiarrheal effects

Recreational uses:

  • Antidepressant effects
  • Anxiolysis
  • Drowsiness or somnolence (nodding)
  • Euphoria
  • Relaxation
  • Sedation
  • Stress relief
Contraindications:
  • Dissociatives like ketamine (K), phencyclidine (PCP), dextromethorphan (DXM), and nitrous oxide ()
  • Sympatholytics like alpha blockers and beta blockers
  • Tranquilizers like alcohol (ethanol), gamma-Hydroxybutyrate (G, GHB), barbiturates, benzodiazepines, and nonbenzodiazepines
  • Other opiates and opioids (narcotics or analgesics)
  • Miscellaneous depressants, anesthetics, hypnotics, and sedatives
Side effects:

Cardiovascular:

Ear, nose, throat, and skin:

  • Flushing
  • Pruritus or itching
  • Xerostomia or dry mouth

Eye:

  • Intermittent blurring
  • Pupil constriction or miosis
  • Visual distortions

Gastrointestinal:

Hepatological:

  • Hepatotoxicity or liver damage (due to acetaminophen or paracetemol (APAP; Tylenol) in many morphine preparations)
  • Liver failure (again, due to acetaminophen)
  • Renal failure or kidney failure

Musculoskeletal:

  • Fasciculation or muscle twitch

Neurological:

  • Analgesia

Psychological:

  • Antidepressant effects
  • Anxiolysis
  • Confusion
  • Drowsiness or somnolence (nodding)
  • Dysphoria
  • Euphoria
  • Relaxation
  • Sedation
  • Stress relief

Respiratory:

  • Bradypnea or slow breathing
  • Dyspnea or shortness of breath
  • Hypoventilation, respiratory depression, or shallow breathing
  • Respiratory acidosis or an abnormal decrease in the pH of the blood
  • Respiratory arrest or cessation of breathing

Miscellaneous/Severe:

  • Miscarriage or spontaneous abortion
  • Coma or unconsciousness
  • Death or termination of life
  • In the United Kingdom, morphine is listed as a Class A drug under the Misuse of Drugs Act 1971 and a Schedule 2 Controlled Drug under The Misuse of Drugs Regulations 2001.
  • In the United States, morphine is classified as a Schedule II drug under the Controlled Substances Act.
  • In Canada, morphine is classified as a Schedule I drug under the Controlled Drugs and Substances Act.
  • In Australia, morphine is classified as a Schedule 8 drug under the variously titled State and Territory Poisons Acts.
  • In the Netherlands, morphine is classified as a List 1 drug under the Opium Law.
  • In Japan, morphine is classified as a narcotic under the Narcotics and Psychotropics Control Act.
  • Internationally, morphine is a Schedule I drug under the Single Convention on Narcotic Drugs.

Although morphine is cheap, people in poorer countries often do not have access to it. According to a 2005 estimate by the International Narcotics Control Board, six countries (Australia, Britain, Canada, France, Germany, and the United States) consume 79 percent of the world’s morphine. The less affluent countries, accounting for 80 percent of the world's population, consumed only about 6 percent of the global morphine supply. Some countries import virtually no morphine, and in others the drug is rarely available even for relieving severe pain while dying.

Experts in pain management attribute the under-distribution of morphine to an unwarranted fear of the drug's potential for addiction and abuse. While morphine is clearly addictive, Western doctors believe it is worthwhile to use the drug and then wean the patient off when the treatment is over.

Further Reading


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