Morphine is a powerful opiate drug that is primarily used to control pain, most often postoperative pain. Opiate drugs, also often referred to as opioids or narcotic drugs, consist of a large class of medications and some illicit substances that were developed from the poppy plant or synthesized from substances that are found in the poppy plant (particularly opium).
These drugs, including morphine, have a particular affinity for pain control because there are neurons in the brain that are already specially adapted for them. These neurons are naturally adapted to be activated by substances that are commonly referred to as endogenous opioids, such as endorphins and enkephalins. Narcotic drugs share a similar chemical makeup to these natural pain-controlling neurotransmitters and therefore readily attach to these neurons in the brain.
Other functions that are controlled by endorphins include hormone regulation, the regulation of respiration, the experience of stress and exertion, and the regulation of coughing and vomiting. In addition, opiate drugs also affect other neurotransmitter systems, such as the dopamine response, and this makes them potential drugs of abuse due to their ability to produce euphoric states, a loss of inhibitions, and feelings of relaxation and wellbeing.
Morphine is classified as a Schedule II controlled substance by the United States Drug Enforcement Administration (DEA), indicating that while it does have utility in the treatment of pain and other conditions, it is also a drug that carries significant risk for abuse and the development of physical and/or psychological dependence.
Morphine is most commonly used in clinical environments, such as hospitals and clinics, and it is not as commonly prescribed as other drugs in its class like Vicodin, Lortab, Norco, etc. Nonetheless, individuals who use morphine for pain control or other uses can only legally obtain the drug if they have a prescription from a physician. Being in possession of morphine products or using morphine without a prescription is illegal.
Even though prescriptions for morphine products have declined due to the development of other narcotic drugs and tight controls imposed by the DEA, it is still not as difficult to obtain morphine as some might believe. The drug is still prescribed to some individuals with chronic pain (e.g., as MS Contin). Individuals who are persistent in trying to get the drug can purchase it illegally, steal from individuals with a prescription, borrow the drug from individuals with a prescription, and purchase online via sites that may be illegally marketing narcotic medications.
Complications Associated with an Opiate Use Disorder
The largest risk associated with abusing morphine is the development of an opiate use disorder (morphine abuse or morphine addiction). Negative ramifications associated with opiate use disorders include:
- Significant negative effects to one’s occupation: This can include decreased productivity at work or actual loss of one’s job.
- Significant negative ramifications to personal relationships: Abuse of morphine results in individuals becoming preoccupied with their drug use and neglecting their personal relationships. This can lead to issues with divorce, separation from children, estrangement from loved ones, etc.
- Issues with education: In the same way that abuse of morphine affects relationships and careers, it can also affect one’s ability to continue with their education.
- Physical health issues: Individuals who abuse morphine are at risk to develop a number of physical health issues that include troubles with their cardiovascular system, respiratory system, liver, and excretory system. These issues can occur as a result of damage to the tissues associated with long-term abuse of these drugs and an increased risk to develop cancer. In addition, individuals who inject morphine are at risk for a number of serious blood-borne diseases related to needle-sharing practices.
- Engaging in other risky behaviors: These can include various dangerous behaviors, such as operating machinery, driving a car, etc., while under the influence of the drug as well as engaging in sex with multiple partners. Often, individuals who obtain morphine illegally are at risk for assault or violence due to the types of suppliers they deal with.
- Financial issues: People often get into financial trouble since the drug can be expensive to buy on the street.
- Mental health issues: Issues with depression, anxiety, and severe isolation may develop.
- Physical dependence: This can develop in individuals who use the drug for longer than 4-6 weeks. Physical dependence occurs as a result of the development of both tolerance (needing more of the drug to get the effects one wants) and withdrawal. Individuals with physical dependence become trapped in a cycle of abuse due to their perceived need to use the drug to avoid negative withdrawal symptoms and the development of tolerance, which forces them to try and obtain more of the drug to meet their needs.
- Overdose: The overdose associated with morphine can be particularly dangerous and even fatal. Because narcotic drugs affect portions of the brain that are involved in the control of vital life-sustaining functions, particularly breathing, an individual who overdoses on morphine can potentially die due to these areas of the brain shutting down, resulting in a cessation of breathing. Overdose on morphine can also lead to issues with oxygen deprivation to organs and areas of the brain as a result of suppressed breathing rates.
Treatment Options for Morphine Addiction
According to most scholarly sources, such as the book Addiction Recovery Management: Theory, Research and Practice, attempting to discontinue use of morphine without being under the supervision of a physician, whether one has used the drug legally or not, is not recommended. This is because individuals who discontinue morphine after chronic use most likely suffer from some level of physical dependence. Individuals abusing the drug have often been taking larger quantities of the drug at relatively regular intervals. This can result in a lengthy and relatively severe withdrawal syndrome.
Even though the withdrawal process itself is not considered to be potentially physically dangerous in most cases, individuals often become emotionally unstable and may engage in risk-taking behaviors that can leave them open to self-harm, poor judgment, and overdose. Individuals may engage in behaviors they would not normally engage in, such as stealing, lying, prostitution, etc., in order to procure the drug and avoid the withdrawal syndrome. Even individuals who are highly motivated to quit using morphine may experience a withdrawal syndrome that is so severe that they inevitably relapse.
The initial phases of treatment for an individual with an opiate use disorder should include some form of physician-assisted withdrawal management to help the individual safely negotiate the withdrawal process. In the case of recovery from morphine, an individual would most likely be given an opioid replacement medication, such as methadone or Suboxone. These medications essentially replace the individual’s opiate drug of choice and can be slowly tapered down over time to allow the person to safely be weaned off narcotic drugs altogether. Other medications can be administered as needed to address specific complications. Withdrawal management is best performed on an inpatient basis where a physician can monitor the client’s progress and make any adjustments on the spot; however, in some cases, individuals may be able to complete the process as an outpatient.
Simply making it through the withdrawal process without complications will not satisfy the requirements of recovery from a substance use disorder. The primary treatment for any substance use disorder is substance use disorder therapy. This form of therapy directly addresses the issues associated with substance use disorders and assists the person in learning positive skills to deal with their issues. This type of therapy can only be delivered by a trained and licensed mental health clinician.
Many individuals will need to rely on others for guidance, support, and camaraderie during their recovery. Social support is a key factor in successful recovery from a substance use disorder. Many individuals find that regular attendance at support groups, such as Narcotics Anonymous and other 12-Step groups, is extremely helpful.
In addition to the above interventions, many individuals with substance use disorders have co-occurring conditions that need to be addressed alongside their substance abuse. Research has indicated that individuals who have co-occurring mental health disorders, such as depression, need to have these disorders addressed at the same time they are treated for their opiate use disorder. This integrated approach will greatly increase the potential that the individual will have overall success in recovery.
Although there is a general outline that is followed in the treatment of an opiate use disorder, the actual implementation of treatment for any individual should be personalized to their specific needs. Thus, other interventions should be administered as needed to assist with the individual’s career, education, personal relationships, or other areas that need assistance.