Morphine is a powerful opioid drug derived from the opium poppy plant. Morphine is one of the most potent pain relievers available and is commonly used to treat post-surgical pain and pain caused by chronic medical conditions. Morphine is a Schedule II controlled substance under the Drug Enforcement Administration’s regulations, signifying the high potential for morphine addiction and abuse. 

When morphine is used repeatedly over time, tolerance may develop. Tolerance means that it takes a higher dose of morphine to achieve the same level of pain relief initially produced. With repeated use of morphine, physical dependence also occurs. Dependence develops when the pain areas of the brain adapt to repeated exposure to the drug and only function properly when morphine is present.

When the morphine is removed, severe physical reactions can occur. These physical reactions are known as withdrawal syndrome. Dependence and addiction involve different areas of the brain, so it is possible to be dependent on morphine without being addicted to morphine. Dependence without addiction can easily occur in people treated with morphine for a chronic medical condition such as cancer.

So, why is morphine addictive? When morphine enters the body, it quickly travels to the brain. Once in the brain, morphine binds to opioid receptors and triggers the release of the neurotransmitter dopamine. Dopamine then produces euphoria and pleasurable feelings in the user. The opioid receptors are located in parts of the brain associated with reward and pain pathways. 

The binding of morphine to areas in the pain pathway leads to loss of pain. However, the binding of morphine to regions of the brain involved in the reward pathway can contribute to the development of addiction. The reward pathway produces pleasurable feelings in response to natural factors such as food and drugs such as morphine.

Morphine binding to receptors in the reward pathways results in dopamine release and euphoria. This euphoria generates a positive reinforcement cycle that leads to repeated morphine use. Once this cycle becomes compulsive, morphine addiction can develop. Although morphine addiction is a serious condition that many people deal with, recovery can be achieved with the proper treatment.

How is Morphine Abused?

There are several ways morphine is abused. Someone using morphine for a medical condition may begin taking a higher dose than prescribed, particularly once tolerance and dependence develop. Snorting, smoking or injecting morphine avoids extended-release pill properties and allows the drug to rapidly enter the brain, resulting in a faster, more intense high. These administration routes also raise the risk for a potentially fatal overdose and can quickly lead to dependence and addiction.

Signs of Morphine Abuse

Detecting morphine abuse may be difficult, particularly in people with a prescription. There are several physical and behavioral signs of morphine abuse and morphine addiction that can be identified in loved ones.

Physical Signs

Several physical signs may indicate that someone is misusing morphine. Physical effects of morphine abuse include:

  • Dilated pupils
  • Nodding off
  • Slurred speech
  • Problems concentrating or focusing
  • Shallow breathing
  • Itching
  • Anxiety

Behavioral Signs

In addition to the physical signs of morphine abuse, several behavioral signs may indicate that someone is misusing morphine. Common behavioral signs of morphine abuse include:

  • Aggression
  • Losing interest in hobbies
  • Personality changes
  • Depression
  • Dramatic changes in priorities
  • Separation from loved ones
  • Poor judgment
  • Problems concentrating or focusing
  • Neglecting daily responsibilities
  • Legal issues
  • Frequently changing doctors
  • Irritability
  • Mood swings
  • Neglect of personal hygiene

Morphine Abuse Side Effects

Both short- and long-term morphine side effects exist. While morphine is an effective pain reliever in patients recovering from surgery or undergoing cancer treatment, morphine addiction and abuse side effects can be severe. Knowing the effects that accompany addiction can help people be aware of their own health and risk level for developing an addiction.

Side Effects

  • Short-Term Side Effects

    Short-term side effects of morphine vary based on the dose, administration route and duration of use. Depending on the administration route, the effects of morphine begin within 15 to 60 minutes and can last for four to six hours. Common short-term effects of morphine include:

    Drowsiness
    Stomach pain and cramps
    Dry mouth
    Headache
    Nervousness
    Mood changes
    Small pupils
    Problems urinating

    Severe short-term morphine side effects that require immediate 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 or itching
    Facial swelling
    Difficulty breathing
    Sweating
    Confusion
    Muscle stiffness

  • Long-term Effects

    Continued morphine use can lead to many adverse health outcomes, including tolerance to the drug, physical dependence and addiction. Long-term effects of morphine addiction and abuse include:

    Mood disorders such as depression
    Immunosuppression (suppressed immune system)
    Chronic agitation
    Severe constipation
    Collapsed veins at injection sites
    Prolonged confusion

Side Effects of Polysubstance Abuse

Polysubstance abuse is defined as the abuse of more than one substance. When morphine is used alongside other substances, severe side effects can occur due to drug interactions and differing physical impact on the body.

Alcohol and morphine are both depressants that calm the central nervous system, decrease heart rate and suppress respiratory function. Thus, mixing morphine and alcohol can increase the risk of severe side effects such as hallucinations, difficulty breathing and extreme dizziness. Alcohol also increases the absorption rate of morphine, increasing the likelihood of kidney or liver damage or accidental overdose.

Morphine and heroin are very similar drugs that exert similar effects on the body. Heroin, which is considered three times stronger than morphine, is converted to morphine within the body. Using morphine and heroin is similar to taking substantial doses of morphine alone and can easily lead to severe side effects and overdose.

The mixture of cocaine and an opioid, such as morphine, is called a speedball. Cocaine is a stimulant, while morphine is a depressant. Both drugs are frequently used together to combine the euphoria and high of both drugs while reducing the adverse effects such as anxiety and drowsiness. Due to the counteracting effects of these drugs, users can unknowingly take more than they usually would because they don’t feel the full effects of one of the substances. Using cocaine and morphine together can easily lead to overdose.

Causes of Morphine Addiction

Biological, psychological and social factors are all known causes of morphine addiction. Morphine binds to receptors involved in the brain’s reward pathways, resulting in a dopamine release. This dopamine release and its corresponding euphoria generate a positive reinforcement cycle that leads to repeated morphine use. Once this cycle becomes compulsive, morphine addiction can develop. 

Genetic factors are also known to play a role in the development of addiction. Psychological factors associated with morphine addiction include past trauma and co-occurring mental health conditions such as mood or personality disorders. Social factors related to morphine addiction include abuse of other substances, substance use by loved ones, peer pressure, access to morphine, poverty and homelessness.

Morphine Withdrawal Symptoms

Prolonged morphine use, with or without a prescription, leads to physical dependence. Withdrawal occurs when a person who developed a physical dependence on morphine stops using it. Morphine withdrawal side effects can occur in as little as six hours after the last dose and severe symptoms typically peak after 48 to 72 hours. Common morphine withdrawal symptoms include:

  • Sweating
  • Runny nose
  • Chills
  • Recurrent yawning
  • Teary eyes
  • Increased heart rate
  • Increased blood pressure
  • Anxiety
  • Headaches
  • Cravings for morphine

More severe morphine withdrawal symptoms include:

  • Fever
  • Insomnia
  • Vomiting
  • Severe Irritability
  • Tremors
  • Stomach and muscle pains
  • Decreased appetite
  • Memory loss
  • Hallucinations

Morphine Addiction Facts and Statistics

According to the CDC, nearly 400,000 people died from overdoses of opioids such as morphine between 1999 and 2017. According to a recent survey by the Substance Abuse and Mental Health Administration, in 2016, nearly 12 million people ages 12 and over misused opioids, including morphine. Over 4% of people report misusing prescription pain relievers, including morphine within the past year. 

People face unique issues when dealing with morphine abuse and addiction depending on their age and gender. Some important morphine addiction facts and statistics include:

  • Prevalence in Men

    According to the National Institute on Drug Abuse, men are more likely than women to use illicit drugs such as morphine

    A recent study by the National Institute on Drug Abuse’s (NIDA) Clinical Trials Network (CTN) on opioid-dependent people found that 89% of men tested positive for morphine

  • Prevalence in Women

    According to the National Institute on Drug Abuse, women and men are equally likely to develop a substance use disorder such as morphine addiction

    A recent study by the National Institute on Drug Abuse’s (NIDA) Clinical Trials Network (CTN) on opioid-dependent people, found that 89% of women tested positive for morphine

  • Prevalence in Teens

    According to the National Institute on Drug Abuse:

    3.40% of 12th graders reported using narcotics, including morphine, in 2018

    3.10% of kids ages 12 to 17 reported using pain relievers

    2.14 million people ages 12 and older had an opioid use disorder in 2016, including 153,000 12 to 17-year-olds

  • Prevalence in Elderly

    According to a study presented at the Gerontological Society of America’s annual meeting, United States hospitals report a nearly 80% rise in emergency room visits among older adults misusing prescription or illicit drugs between 2006 and 2012; roughly 11% of these visits were related to opiates, including morphine

    According to a report by the Agency for Healthcare Research and Quality (AHRQ):

    Almost 125,000 hospitalizations among elderly Americans were linked to opioids in 2015

    In 2015 and 2016, almost 4 million seniors, on average, filled four or more opioid prescriptions

Morphine Abuse and Treatment Trends in South Florida

Opioid misuse, including morphine addiction and abuse, is an epidemic both nationally and in Florida. The Florida Department of Law Enforcement (FDLE) reported that the occurrence of morphine use increased by 38% and deaths caused by morphine increased by 49% from 2015 to 2016. 

According to the 2017 Southeastern Florida Sentinel Community Site (SCS) Drug Use Patterns and Trends report, the number of opioid deaths, including those linked to morphine, rose between 2014 and 2015 — from roughly 250 to nearly 400 deaths. In the three southeasternmost Florida counties, morphine was linked to 268 deaths in the first half of 2016. 

To help combat the opioid epidemic, drug take-back programs allow people to bring unused drugs, including morphine, to a central location for safe disposal. Pharmacists, local law enforcement departments or trash and recycling services can provide information on available take-back programs.

Morphine Overdose

Morphine overdoses, whether accidental or intentional, are life-threatening and require immediate medical attention. If the victim collapsed, had a seizure, has difficulty breathing or is unconscious immediately call 911. People who take morphine should have a rescue medication called naloxone available for use by their family or friends in case of an overdose. Naloxone blocks the effects of morphine, thereby preventing life-threatening symptoms. Signs of a morphine overdose may be challenging to see at first but will quickly escalate in severity without treatment. Morphine overdose symptoms include:

  • Slow, shallow or irregular breathing
  • Sleepiness
  • Slurred speech
  • Loss of consciousness
  • Limp muscles
  • Hallucinations
  • Cold, clammy skin
  • Small pupils
  • Slow heartbeat
  • Blue or purple-colored fingernails
  • Blurred vision
  • Nausea
  • Fainting

How to Help Someone Addicted to Morphine

If someone is concerned that their loved one is misusing morphine, it is essential to watch for signs and symptoms of morphine addiction. They should encourage their loved one to seek professional addiction treatment immediately to avoid dangerous health effects. It is vital they offer support without judgment or placing blame. Becoming informed about morphine and morphine addiction can also help build an understanding of what their loved one is going through.

Intervention

An intervention can be an effective way to encourage a loved one to seek treatment. During an intervention, a group of people, including friends, family and colleagues come together to confront the person who is addicted to morphine. During the intervention, they try to persuade their loved ones to seek help for their addiction. Professional intervention specialists or treatment facilities can also help plan an intervention for morphine addiction.

Treatment Options for Morphine Addiction

Seeking treatment for morphine abuse and addiction is an essential step in achieving recovery and regaining a healthy body and strong relationships. Choosing a suitable treatment option for morphine addiction depends on the person’s needs and life situation. Morphine addiction treatment options include:

  • Detox: Morphine withdrawal symptoms can be severe, so medical detox is recommended. During morphine detox treatment, medical professionals closely monitor the patient and administer supportive therapy and medications to ease withdrawal symptoms.
  • Residential: After the completion of detox, patients may enter a residential rehab program. During residential programs, patients live onsite full time and receive continual medical supervision while participating in counseling sessions and group therapy.
  • Outpatient: After the completion of residential treatment, or as an alternative to residential programs, patients join an outpatient program. Outpatient programs involve regular clinic visits and group therapy meetings while the patient returns to their usual life.
  • Teletherapy: Teletherapy and online substance abuse counseling is available for those struggling with substance abuse and mental health issues. Partial Hospitalization (PHP), Intensive Outpatient (IOP) and Outpatient levels of care commonly qualify for online substance abuse treatment.
  • Dual Diagnosis: Morphine addiction commonly occurs alongside mental health conditions such as borderline personality disorder (BPD), bipolar disorder, depression, anxiety, and post-traumatic stress disorder (PTSD). The frequent co-occurrence of morphine addiction with mental health conditions makes treatment harder, although full recovery is possible with treatment tailed to both conditions.

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Key Points: Understanding Morphine Abuse

Morphine is a commonly abused drug; therefore, it is important to be aware of these key points about morphine abuse:

  • Morphine abuse can lead to tolerance, dependence and addiction
  • The binding of morphine to areas of the brain involved in the reward pathway can contribute to the development of morphine addiction
  • Several physical and behavioral signs can be used to identify morphine abuse and morphine addiction in loved ones
  • When morphine is used alongside other substances, severe side effects and overdoses can occur
  • Morphine withdrawal side effects can occur in as little as six hours after the last dose and can be severe
  • Morphine abuse is a growing epidemic among men, women, children and the elderly
  • With proper treatment, including detox and professional inpatient and outpatient treatment programs, full recovery from morphine addiction can be achieved

If you or a loved one struggle with morphine addiction, contact The Recovery Village Palm Beach at Baptist Health to speak with a representative who can guide you through the initial steps of getting addiction treatment. You deserve a healthier future, call today.

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.