Morphine is the original opioid drug. Since its first isolation in 1805, morphine has become a mainstay pain reliever in the medical field. When used medically, morphine is an effective pain reliever during surgical recovery and for managing chronic medical conditions such as cancer.
However, over time, tolerance and dependence to morphine develops and can lead to misuse. Recreational morphine use is also common and can lead to addiction and dangerous side effects.
What Is Morphine?
Morphine is a powerful, naturally derived narcotic analgesic (i.e., pain reliever) isolated from the opium poppy plant. Morphine works by changing the way the brain and nervous system responds to pain along with producing euphoria. Morphine is commonly formulated as morphine sulfate, which allows the drug to absorb into the body easily.
Morphine is available in both short-acting and long-acting options. Short-acting formulations are usually taken as needed for pain, while long-acting versions are used for 24/7 pain treatment. While effective at treating pain, morphine is highly addictive. As a result of its addictive potential, morphine is currently classified as a Schedule II narcotic under the federal government’s Controlled Substances Act.
What Is Morphine Used For?
Morphine is used for the treatment of moderate to severe pain. Morphine is commonly used to treat temporary pain after surgery or heart attacks and to manage chronic pain from medical conditions such as rheumatoid arthritis and cancer. Morphine is also sometimes used to treat pain during childbirth. Occasionally, morphine is used as a cough suppressant or to assist with anesthesia during surgical procedures.
Morphine is a type of drug called an opioid. Opioids are substances that act on opioid receptors found in the central and peripheral nervous system. Other common opioids include heroin, fentanyl, oxycodone, hydrocodone and codeine. Morphine is marketed under several generic and brand name products, including:
- MS-Contin
- Oramorph SR
- MSIR Solution
- Roxanol
- Kadian
- RMS
- Astramorph
- Duramorph
- Infumorph
Dosage and Administration
Morphine formulations include injections, oral solutions, tablets, capsules and suppositories. Tablets and capsules come in immediate and extended-release formulations. Different morphine doses are needed depending on the patient, their pain level and their history of morphine use.
Patients who never used morphine before will need a lower dose compared to patients who have a history of morphine use, as a drug tolerance can occur over time. Morphine dosage regimens vary depending on the formulation used and the intended treatment purpose. Some normal doses of morphine include:
Oral immediate-release formulation:
- Tablets: 15 mg to 30 mg orally every four hours as needed
- Oral solution: 10 mg to 20 mg orally every four hours as needed
Oral extended-release formulation:
- Tablets: 15 mg orally every 8 or 12 hours
- Capsules: 30 mg orally every 24 hours
Injectable formulation:
- Intravenous (IV): 0.1 mg to 0.2 mg per kilogram via slow IV injection every four hours, as needed
- Intramuscular (IM): 10 mg every four hours, as needed (based on a 70 kg adult)
The lethal dosage of morphine varies depending on the patient and their previous morphine use. The minimum lethal dose of morphine sulfate is reported as 120 mg. However, the lethal dose can be as low as 60 mg in susceptible patients or as high as 3000 mg in tolerant patients.
What Does Morphine Look Like?
Morphine formulations include injections, oral solutions, tablets, capsules and suppositories. The appearance of morphine depends on the formulation. Morphine immediate-release tablets are white and round. Extended-release morphine tablets are round, oval or capsule-shaped and can be blue, green, purple, pink, brown, orange or grey. Morphine tablets and capsules are imprinted with a unique number to assist with identification. Morphine oral suspensions are typically blue-green or green. People prescribed morphine may wonder, “What does a 15mg or 30mg morphine pill look like?” The appearance of commonly prescribed morphine sulfate pills varies:
15 mg immediate-release:
- White
- Round
- 54 733 imprint
15 mg extended-release:
- Blue
- Round
- 15 M imprint
30 mg immediate-release:
- White
- Round
- 54 262 imprint
30mg extended-release:
- Purple
- Round
- 30 M imprint
Street Names for Morphine
Because morphine is often distributed illicitly, dealers and buyers come up with nicknames for the drug to increase the covertness of their actions. There are many different street or slang names for morphine, including:
- Mister Blue
- Emsel
- First Line
- Morphs
- Hows
- MS
- Unkie
- Morphos
- Dreamer
- God’s Drug
- Miss Emma
- M
- S.
- Salt and Sugar
- White Lady
Knowing the street names for morphine can help people look out for their friends’ and family members’ health.
Morphine Side Effects
What are the side effects of morphine or morphine sulfate? Morphine may cause numerous physical and psychological side effects, some of which are life-threatening. Medical attention should be sought if concerning side effects occur while using morphine.
Elderly
Morphine is very effective at treating pain in elderly patients. However, the effects of morphine on the elderly may be different from those in younger patients. Morphine metabolism involves the liver and kidneys, so elderly patients with liver or kidney disease may be sensitive to morphine or experience more severe side effects. Elderly patients may have decreased kidney function even without kidney disease, leading to a build-up of the drug in their body. Thus, care must be taken to avoid overdose in elderly patients. Elderly patients with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and emphysema should also use caution when prescribed morphine, as respiratory suppression is a known side effect of morphine use. Morphine side effects in elderly patients must be closely monitored to prevent dangerous medical events.
Physical
Both desirable and undesirable health effects of morphine exist. While it is an effective pain reliever for patients recovering from surgery or undergoing cancer treatment, dangerous side effects can occur. Common physical effects morphine has on the body include:
- Drowsiness
- Stomach pain and cramps
- Dry mouth
- Headache
- Nervousness
- Mood changes
- Small pupils
- Problems urinating
Serious side effects that could indicate the need medical attention include:
- Change in skin color
- Changes in heartbeat
- Agitation
- Hallucinations
- Nausea or vomiting
- Decreased sexual desire
- Seizures
- Extreme drowsiness
- Dizziness or fainting
- Chest pain
- Fever
- Hives
- Rash
- Itching
- Facial swelling
- Difficulty breathing
- Sweating
- Confusion
- Muscle stiffness
Psychological
The psychological effects of morphine include changes in mood and pain perception. Common morphine mental effects include:
- Feelings of euphoria
- Intensified relaxation
- Loss of pain or decreased perception of pain
- Reduced worry and stress
How Long Does Morphine Stay in Your System?
Morphine users may wonder, “How long does morphine stay in your system?” Many factors impact how long morphine stays in the body. These factors include:
- Age: Younger people generally clear morphine faster than older people due to how their organs process the drug.
- Size: Weight, height and body fat percentage impact how quickly morphine is processed and eliminated from the body.
- Genetics: Several genetic factors impact how long morphine stays in the body.
- Kidney and liver function: Morphine is mainly processed in the liver and its metabolites are excreted through the kidneys, so the function of these organs impacts how quickly the drug is processed.
- Metabolism: The speed at which a person’s body metabolizes drugs impacts morphine’s clearance.
- Frequency and duration of use: Low doses or using morphine for a short time will result in faster removal compared to high doses or continued use.
- Use of other substances: The use of other drugs or alcohol can impact clearance of morphine from the body.
Due to these factors, there is significant variation in how long morphine stays in each person’s body. Studies show that peak blood morphine concentrations occur within one hour of oral administration and within 5 minutes after intravenous injection. One technique to measure how long a drug will last in the body is to measure its half-life. The half-life is the time it takes for half of the drug to be eliminated from the body. The half-life of morphine after intravenous (IV) administration is usually two to four hours, but can be as long as 15 hours. Thus, IV morphine can stay in your system for several days.
Current laboratory testing methods suggest the following timeframes for how long morphine stays in blood, urine and hair:
- Blood: Morphine can be detected in the blood for up to 12 hours.
- Urine: Morphine can be detected in the urine for two to three days.
- Hair: Morphine can be detected within a hair follicle for up to 90 days.
Is Morphine Addictive?
Morphine works by binding to opioid receptors in brain regions involved in feeling pain and pleasure. Upon binding to these receptors, pain signals are blocked and large quantities of dopamine are released. Dopamine is a neurotransmitter that produces happy, calm and euphoric feelings. These feelings can reinforce the act of repeatedly taking morphine. Over time, this cycle can lead to morphine dependence and addiction.
Morphine is categorized as a Schedule II substance under the federal government’s Controlled Substances Act, meaning it has a high potential for abuse and severe psychological or physical dependence. Morphine users commonly develop a tolerance to the drug and require higher doses over time to achieve pain relief. Even when used as directed, the U.S. Food and Drug Administration (FDA) advises that morphine use can lead to physical dependence. A survey by the Substance Abuse and Mental Health Administration, in 2016, nearly 12 million people ages 12 and over misused opioids, including morphine. When morphine use becomes compulsive, an addiction to the drug develops.
- Signs of Morphine Abuse
Physical Signs:
Dilated pupils
Nodding off
Slurred speech
Problems concentrating or focusing
Shallow breathing
Itching
Behavioral Signs:
Aggression
Losing interest in hobbies
Dramatic changes in priorities
Separation from loved ones
Problems concentrating or focusing
Legal issues
Frequently changing doctors
Irritability
Mood swings
Neglect of personal hygiene
If you or a loved one live with a morphine addiction, contact The Recovery Village Palm Beach at Baptist Health to speak with a representative who can help you take the first steps toward a substance-free future. You deserve good health, call today.
- Sources
Canadian Institute of Health Research. “Morphine.” July 8, 2019. Accessed July 9, 2019.
Drug Enforcement Administration. “Morphine.” February 10, 2019. Accessed July 9, 2019.
Drugs.com. “Morphine.” January 13, 2019. Accessed July 9, 2019.
National Institutes of Health. “Street & Commercial Names.” January 17, 2018. Accessed July 9, 2019.
MedlinePlus. “Morphine Injection.” June 17, 2019. Accessed July 9, 2019.
Food and Drug Administration. “MS Contin.” March 4, 2009. Accessed July 9, 2019.
National Traffic Highway Safety Administration. “Drugs and Human Performance Facts Sheets.” April, 2004. Accessed July 9, 2019.
National Institute on Drug Abuse. “What are prescription opioids?” June, 2019. Accessed July 9, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.
