What is morphine?

Morphine is an opioid pain medication. An opioid is

sometimes called a narcotic.
Morphine is used to treat moderate to severe pain.
Short-acting formulations are taken as needed for pain.
The extended-release form of this medicine is for
around-the-clock treatment of pain. This form of
morphine is not for use on an as-needed basis for pain.
Morphine is not for treating short-term pain just after
surgery unless you were already taking morphine before
the surgery

Sign effect morphine

Abdominal or stomach pain
blurred vision
bulging soft spot on the head of an infant
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling
feelings
change in the ability to see colors, especially blue or yellow
chest pain or discomfort
confusion
cough
decreased urination
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or
sitting position
fainting
fast, pounding, or irregular heartbeat or pulse
headache
hives, itching, or skin rash
increased sweating
loss of appetite
nausea or vomiting
nervousness
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
severe constipation
severe vomiting
shakiness in the legs, arms, hands, or feet
shortness of breath
slow heartbeat
sweating or chills
wheezing

By Dr Ananya Mandal, MD
Morphine is the most abundant
analgesic opiate found in opium and is
a potent pain reliever. The drug is
used in clinical pain relief but is also
used illicitly for recreational purposes
among drug users. It is potentially
highly addictive and can cause
intense physical dependence that
leads to abuse of the substance.

- Morphine is obtained from the seedpod extract or

opium found in the poppy plant, Papaver somniferum
- Morphine is widely used in clinical pain management,
especially for terminal cancer pain and post-surgery
pain. In the body, morphine has several effects
including reduction of pain, loss of hunger, and
suppression of cough.
Some of the clinical uses of morphine include:
- Pain relief after surgery
- Pain relief after major trauma or injury except head
injuries
- Pain relief in advanced cancers with terminal cancer
pain

Before using morphine

should not take this medicine if you
have ever had an allergic reaction to
morphine or other narcotic medicines,
or if you have:
severe asthma or breathing problems;
a blockage in your stomach or
intestines; or
a bowel obstruction called paralytic
ileus.

 Gastrointestinal side effects - These include nausea, vomiting, abdominal cramps and constipation.
Opioid receptors for morphine are present in the gastrointestinal tract and their activation may lead to
a slowing of gut movement, leading to constipation. Long-term use leads to severe constipation. In
addition, morphine stimulates the vomiting centre of the brain causing nausea and vomiting. Morphine
and codeine cause more nausea than other opioids. There may be drying of the mouth as well.
Sedation - Named after Morpheus, the Greek god of dreams, morphine is one of the most powerful
sedative opioids. People taking morphine are therefore advised to refrain from driving and operating
heavy machinery to avoid accidents.
Skin changes - Morphine may lead to the release of histamine in the skin leading to warmth, flushing
and urticaria or allergic eruptions across the skin. Skin may appear cool and clammy and a severe chill
called hypothermia may develop.
Shrunken pupils - Morphine may cause the pupils to constrict and appear pin-pointed in size.
Respiratory depression - The breathing mechanism can become suppressed in response to low blood
oxygen. In healthy individuals, as blood oxygen falls and blood carbon dioxide rises, the drive for
breathing increases. However, morphine suppresses this drive in the brain, potentially causing this very
dangerous side effect. Respiratory depression is more common with higher doses.
Initial doses lead to euphoria but at higher doses unpleasant symptoms such as hallucinations,
delirium, dizziness and confusion manifest. There may be some amount of headache and memory loss.
Biliary colic and subsequent severe abdominal pain is common in morphine overdose.
With high doses, muscle rigidity and abnormal movement of the limbs and muscles called myoclonus
may manifest.
One of the prominent side effects of morphine use is the development of physical or psychological
dependence on the drug and withdrawal symptoms when the drug is stopped. Morphine is a highly
addictive substance and some of the withdrawal symptoms include pain, loss of sleep, nausea,
vomiting, diarrhea, goose bumps, hot and cold flashes and intense craving.
Development of tolerance - Tolerance describes when a person needs to take a drug in higher doses to
achieve the same degree of e.g. euphoria or pain relief as before. Developing a tolerance in this way
often means addicts use higher doses of the drug.