The opiate crisis in America continues to spread across the country causing addiction and death rates to increase. While there are many types of opiates, the most common are morphine, codeine, oxycodone, and hydrocodone. Morphine is the main component of the poppy plant. It is one of the most potent analgesic opiates and has been used for pain relief for many years. It is a prescription medicine that is used to treat moderate to severe pain. Morphine is also used to reduce pain following surgical procedures.
Morphine is most commonly used in a hospital setting, however, because it is readily available outside of medical settings, there is a high risk for misuse and abuse. Morphine can be taken orally, intravenously and rectally. It can be smoked or snorted as well.
Currently, there are only four countries that legitimately grow poppy plant crops for medicinal use. These countries include Australia, France, Spain, and Turkey. These countries have been authorized to grow the plants to meet the increasing demands for opiates by the United Nations International Narcotics Control Board.
This is not to say that these are the only countries the plants can be found, they may also be found in places like Thailand, Afghanistan, Columbia, and Mexico. These countries have been known to grow unregulated crops for illicit use on the black market.
- Severe to moderate pain
- Accident victims
- Cancer patients
- HIV/AIDS pain management
- Major surgery patients
- Kidney stone pain
- Chronic back pain
The CDC reports that nearly half of the accidental drug overdoses in the United States were caused by heroin and morphine. Other opiates and morphine statistics include:
- Every day, 60 people die from opioid pain medications, which is equal to roughly 22,000 people per year.
- 19 million Americans are addicted to opioid painkillers.
- 10 percent of the U.S. population has abused an opiate drug in their lifetime.
- The number of people addicted to morphine admitted to the emergency room increased by 106 percent between the years of 2004 and 2008.
- More than 60 percent of people addicted to morphine admitted to getting the drug from friends or relatives.
- Morphine is a Schedule II drug under the Controlled Substances Act, which means it is subject to regulations and controls around how often a prescription can be written and refilled.
The U.S. National Library of Medicine identifies the numerous brand names for prescriptions containing morphine that are both advertised and used in the United States.
The brand names for morphine drugs are:
The U.S. Drug Enforcement Administration (DEA) estimates that out of the 130 to 140 tons of morphine imported into the United States annually, only 15% is used as is. The remaining 85% of morphine stock is converted to other popular morphine-based medicines, such as:
- Hydromorphone (Dilaudid®)
- Oxymorphone (Numorphan®),
- Methadone (Dolophine®)
- Oxycodone (Roxicodone®, Percodan®, Percocet®)
When injected into the veins, morphine is transferred through the bloodstream to the brain almost as quickly if it is smoked. People have also been known to snort heroin or morphine to avoid the use of needles and problems frequently associated with needle use.
Once morphine reaches the brain, it binds to opiate receptors in certain parts of the brain that are associated with the reward center pathways. These areas include the cerebral cortex, VTA, nucleus accumbens and the cortex. Morphine also attaches to the parts of the brain that are involved in the pain pathways. These areas include the thalamus, brainstem, and spinal cord. Binding of morphine to the reward center pathways is what causes the euphoria and relaxation effects associated with opiates. However, this is what also leads to respiratory depression and other dangerous and life-threatening effects of opiate use.
- Feelings of euphoria
- Intensified relaxation
- Loss of pain or decreased perception of pain
- Reduced worry and stress
Morphine has a very high potential for addiction because of how it reacts with the brain’s reward pathways and because of its potency. Someone taking morphine often wants to continue taking it to obtain the sense of euphoria they felt after initial use. Tolerance, physical and psychological dependence can develop very quickly which causes it to be a commonly abused drug.
One of the many dangers with morphine abuse is the potential for causing breathing problems and paralysis of the lungs. This can be a life-threatening respiratory issue that occurs in people who frequently use or combine morphine with alcohol or other drugs.
Even though morphine has a relatively short half-life, it tends to stay in the central nervous system longer than other opiates like Fentanyl. This is due to the low lipid solubility of morphine, which makes it more difficult for morphine to cross the blood-brain barrier.
The peak life for a morphine injection is about 20 minutes with a half-life at only 1.5 hours. Whereas, if morphine is taken orally, it reaches a peak after around 30 minutes and has a longer half-life lasting anywhere from 2 to 4 hours.
Several factors contribute to clearance rates of morphine and how long it will stay in someone’s system. Two people could take the same dose amount, in the same timeframe and one may excrete morphine quicker than the other. The most important factors to consider are:
- Age: The younger someone is, the more likely they are to eliminate drugs faster from their systems because their metabolism is likely moving at a faster pace and their organs are usually in better shape than those of an older person.
- Body height /weight /fat: Depending on how tall someone is, how much they weigh and how much body fat a person has may cause them to eliminate faster than someone else when we compare their dosage amounts.
- Genetics: Genes are important factors in not only how a person’s organs and metabolism are built, but also their predisposition for addiction.
- Function of the Kidney & Liver: The liver and kidney are vital organs in the elimination process of the body. If a person has a damaged liver or kidney, their clearance rate will be longer.
- Metabolism: The speed at which a person can metabolize his or her food, liquids or drugs will affect how quickly morphine is processed through the body.
- Frequency of use: Someone who only takes a single dose is going to eliminate morphine faster from their system compared to someone who has been using it for an extended time at much higher doses.
Related Topic: How long do opioids stay in your system
The National Highway Traffic Safety Administration provides some estimates for the amount of time it takes morphine to leave the system. Some estimated range of times, or detection windows for drug testing, that someone who uses morphine can expect it to be discovered by several testing methods:
- Urine: Morphine can be detected in the urine for 2-3 days
- Hair: Morphine, like many other drugs, can be detected with a hair follicle drug test for up to 90 days.
- Blood: A blood test can identify Morphine for up to 12 hours.
Each person experiences varying levels of discomfort associated with morphine withdrawal. This depends on several factors, to include regularity of use, duration of use and ability of the body to clear morphine from the system. Each of these factors, among other things, can impact the intensity and duration of withdrawal symptoms.
When coming off of morphine, it’s highly advised to go through the detox process under medical supervision with a trained professional. Undergoing medical detox for opiate withdrawal from morphine is the best way to ensure that painful and uncomfortable side effects are mitigated as best as possible.
The withdrawal process is what often keeps someone addicted, because it can be so unpleasant it may discourage them from completing detox. Going through the detox process in a supervised medical setting can help someone through the process by providing encouragement and managing the symptoms and possible complications of opiate withdrawal.
Morphine withdrawal symptoms may include:
- Sweats and chills
- Stomach cramps or diarrhea
- Fast heartbeat and breathing rate
- Trouble sleeping
- Joint or muscle pain
- Loss of appetite
- Nausea and vomiting
- Runny nose
- Weakness or fatigue
Once someone has completed the withdrawal and detox process from morphine, long-term treatment like an inpatient or outpatient program is recommended. Opiate addiction from morphine should be addressed after detox as the next phase towards recovery so that any underlying causes can be identified and worked through.
Guide for Estimating Requirements for Substances Under International Control, International Narcotics Control Board, https://www.incb.org/documents/Narcotic-Drugs/Guidelines/estimating_requirements/NAR_Guide_on_Estimating_EN_Ebook.pdf, February 2012
Increases in Drug and Opiod Overdose Deaths, Center For Disease Control, https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm, January 2016.
Drugs The Straight Facts: Morphine, State University of New York at Buffalo, http://iftandcs.org/Addictions/Drugs%20The%20Straight%20Facts,%20Morphine.pdf, Gregory Busse
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