Must to Know About Morphine Addiction
Recovery from morphine addiction is possible with proper treatment and lifestyle modifications, regardless of one’s background.
Morphine has been used as a pain reliever for over two centuries and may have been prescribed to alleviate moderate to severe pain, leading to its use.
However, tolerance may develop, and taking more may be required to achieve the desired effect. When trying to decrease usage, withdrawal symptoms may arise.
It’s possible that despite your attempts to reduce your morphine intake, you have not been successful.
You might have developed a strong craving for the drug and spend a significant amount of time thinking about it, obtaining it, and using it. If you’re worried, rest assured that you’re not alone, and you may be exhibiting signs of dependence and addiction.
Nevertheless, morphine addiction, like any other, can be controlled with a robust recovery strategy.
Language matters
In this article, the term “addiction” is used informally, as it has been replaced with “substance use disorder” in diagnostic manuals.
The use of this new term allows for a more specific categorization of the disorder, ranging from mild to severe, which can then inform appropriate treatments. Severe substance use disorder may be colloquially referred to as addiction.
The term “substance use disorder” encompasses a broad range of disorders that involve the compulsive use of substances and chronic relapse. Therefore, what is commonly referred to as addiction is actually substance use disorder.
What is morphine?
Morphine is a powerful opioid pain medication used to treat moderate to severe pain. It is derived from the opium poppy and works by binding to opioid receptors in the brain and spinal cord, blocking pain signals and producing feelings of euphoria and relaxation.
It is a controlled substance and can be highly addictive. Morphine is available in various forms, including tablets, injections, and patches.
Opioids, such as morphine, work by interacting with opioid receptors in the brain. This class of drugs has been associated with addiction and dependence. In the United States alone, it is estimated that around 3 million individuals are affected by opioid addiction. On a global scale, this number increases to 16 million people.
Morphine is available as:
- short- and long-acting tablets
- injections
- intravenous (IV) administration
- suppositories
Morphine is commonly prescribed by doctors to manage moderate to severe pain, such as after a surgery or during cancer treatment. It is also used in end-of-life palliative care to provide comfort to patients.
You may see morphine prescribed under several brand names. These include:
- Avinza
- Kadian
- MS-Contin
- MSIR
- Oramorph SR (discontinued in the United States)
- RMS
- Roxanol
What morphine does to your brain and body
Morphine, which derives its name from Morpheus, the Greek god of dreams, alters the way your body perceives pain and can induce a feeling of euphoria depending on the amount taken and your body’s response.
Holly Schiff, a licensed clinical psychologist practicing in New York and Connecticut, explains that morphine aids in the release of dopamine, a neurotransmitter that obstructs pain signals and induces pleasurable sensations. This mechanism is why morphine is effective as a pain reliever.
While taking morphine in minimally effective doses for the recommended duration may not necessarily result in dependence, larger or unnecessary high doses can lead to it.
Holly Schiff, a licensed clinical psychologist in New York and Connecticut, explains that the pleasurable feelings caused by morphine’s release of dopamine can create a reward system that leads to craving and, ultimately, physical dependence.
Misuse of morphine
In the US, morphine is categorized as a Schedule II controlled substance, indicating its high potential for abuse or dependence.
Gradual morphine misuse may not be noticeable to the individual. A person may start taking the drug a little earlier each time, reducing the time between doses. Over time, this can increase and lead to misuse.
Jeff Chervenak, a therapist and recovery coach in Avon, Connecticut, suggests that if someone starts making excuses to use morphine beyond the need for pain relief, it could be a red flag.
Misuse of morphine can cause:
- confusion
- constipation
- dizziness
- drowsiness
- itchiness
- labored breathing
- lowered blood pressure
- upset stomach, nausea, or vomiting
What’s an addiction?
The manifestation of addiction varies from person to person.
Essentially, addiction refers to the inability to cease engaging in a pleasurable activity despite the negative consequences or adverse effects it may have.
It is categorized into two groups:
Physical addiction (or dependence)
Your body develops a chemical reliance on the substance, leading to distressing withdrawal symptoms when you attempt to stop taking it. Reintroducing the substance into your system helps your body return to a state of equilibrium.
The chemical dependence on a substance means that the body has adapted to the presence of the drug and relies on it to maintain normal functioning.
If the drug is suddenly removed, the body will experience withdrawal symptoms, which can include nausea, vomiting, sweating, tremors, and anxiety. When the substance is reintroduced into the body, it brings the body back to a state of equilibrium, but over time, the body can develop a tolerance, requiring higher doses to achieve the same effect.
This can lead to a cycle of increasing use and potential addiction.
Psychological addiction
In some cases, you may develop an emotional or compulsive attachment to the substance due to its perceived effects, which can alter your behavior, thoughts, and actions.
When you have an addiction, you may prioritize using the substance over other important aspects of your life, such as work, relationships, or personal responsibilities.
You may also continue to use the substance despite negative consequences, such as health problems or legal issues.
Additionally, you may develop a tolerance to the substance, meaning you need higher doses to achieve the desired effects, and this can lead to increased risk of overdose.
Signs and symptoms of addiction to morphine
To put it differently, around 8 to 12% of individuals who use opioids over a long period of time to manage chronic pain will experience opioid use disorder.
In sum, according to the DSM-5, symptoms of morphine use disorder include:
- taking a substance in larger amounts than prescribed by a health professional
- taking a substance for longer periods of time than originally intended
- unsuccessful efforts to decrease or discontinue use
- spending significant time thinking about, using, or planning to get the drug
- intense cravings or urges for consuming the substance
- significant impairment in social interactions, cognitive functions, or productivity
- neglecting or giving up on occupational, social, or leisure activities
- using the drug in situations in which it may be physically risky to do so
- using the substance despite being aware of or experiencing health challenges from it
- tolerance to the drug (requiring an increased dose to achieve desired effects)
- experiencing withdrawal symptoms when decreasing or ceasing to use the substance
Tolerance and withdrawal symptoms are not conclusive indicators of substance use disorder, as other symptoms need to be present as well.
For example, according to Schiff, some indications of morphine addiction may include the failure to fulfill important duties at work, school, or home, while spending a significant amount of time searching for or using the drug.
Other possible signs may include:
Physical
- Drowsiness or sedation
- Slowed breathing or difficulty breathing
- Constricted or pinpoint pupils
- Nausea and vomiting
- Itching or flushed skin
- Constipation
- Reduced sex drive or sexual function
- Changes in appetite and weight
- Muscle aches and pains
- Poor coordination or balance
- Increased pain sensitivity
Cognitive
- Difficulty with memory and concentration
- Impaired decision-making abilities
- Lack of insight into the severity of the addiction and its consequences
- Denial about the extent of the addiction or attempts to minimize it
- Obsessive thinking about obtaining and using the drug, even when it interferes with other aspects of life.
Psychological
- Cravings and preoccupation with obtaining and using the drug.
- Continued use despite negative consequences.
- Mood swings and irritability.
- Anxiety and depression.
- Poor decision-making and impaired judgment.
- Agitation and restlessness.
- Changes in personality and behavior.
- Difficulty with memory and concentration.
- Denial of addiction or minimization of the problem.
- Loss of interest in activities once enjoyed.
Behavioral
- Changes in social activities: Someone addicted to morphine may lose interest in previously enjoyed social activities or hobbies and may withdraw from family and friends.
- Continuing to use the drug despite negative consequences: Even if someone recognizes the harm that their morphine use is causing, they may continue to use it despite negative consequences, such as legal problems or relationship issues.
- Seeking out the drug: Someone addicted to morphine may spend a lot of time and energy seeking out the drug, including visiting multiple doctors or pharmacies to obtain multiple prescriptions.
- Taking larger doses or using the drug more frequently than intended: Someone with an addiction to morphine may find that they need to take more of the drug to achieve the desired effect or that they are using the drug more frequently than they intended.
- Hiding drug use: Someone addicted to morphine may hide their drug use from others or lie about how much or how frequently they are using the drug.
Signs of morphine overdose
More than 120,000 people die from opioid overdoses every year, around the world.
Globally, opioid overdoses cause over 120,000 deaths annually.
A medical emergency is warranted in the case of a morphine overdose.
- Severe respiratory depression or difficulty breathing
- Extreme drowsiness or unresponsiveness
- Constricted (small) pupils
- Cold and clammy skin
- Blue or purple lips and nails
- Slow heart rate
- Low blood pressure
- Muscle weakness or limpness
- Confusion or disorientation
- Seizures or convulsions
- Loss of consciousness or coma
If you or someone you know is experiencing an overdose of morphine, immediate medical attention is necessary. It is recommended to call 911 or visit the nearest emergency room for urgent care. You may also contact poison control at 800-222-1222 for assistance.
Who is more vulnerable to developing a morphine addiction?
You may have a higher chance of developing a morphine use disorder if you have:
- a genetic predisposition
- some mental health conditions
- personal history of substance use
- family history of substance use
- repeated morphine use from chronic pain
- lack of a support network
Chervenak explains that morphine stimulates the reward pathways in the brain, which is different from the usual ways we experience pleasure through our behavior.
This can be particularly intense for people who are dealing with other stressors in their lives or have a history of trauma. It’s possible to experience this effect without being aware of it.
Chervenak adds that many people may not realize they have a history of trauma, but still feel a powerful sense of comfort when taking morphine.
Withdrawal symptoms
A recommended approach for quitting morphine is to do it under the supervision of a trusted healthcare professional. While it can be difficult, having the guidance of an expert can make the process more manageable.
Withdrawal symptoms from morphine can vary from person to person and can be influenced by various factors, including the duration and amount of use. Some common withdrawal symptoms include:
- Anxiety
- Restlessness
- Irritability
- Insomnia
- Muscle aches and pains
- Sweating
- Abdominal cramps
- Nausea and vomiting
- Diarrhea
- Dilated pupils
- Goosebumps
- Rapid heartbeat
These symptoms typically begin within the first 12 hours after the last dose and peak within 2-3 days. They can last for several days to weeks, depending on the severity of the addiction and individual factors.
How to recover from a morphine use disorder
Medication-assisted treatment (MAT)
Medication-assisted treatment (MAT) involves the use of medications, in combination with behavioral therapies and counseling, to provide a comprehensive approach to addiction treatment. MAT is often used for opioid addiction and involves the use of medications like methadone, buprenorphine, or naltrexone to help manage withdrawal symptoms and reduce cravings.
These medications work by binding to the same receptors in the brain that opioids bind to, helping to reduce withdrawal symptoms and cravings without producing the same euphoric effects as opioids.
MAT is often used in conjunction with counseling and therapy to address the underlying causes of addiction and promote long-term recovery.
Here are some examples of medications used in medication-assisted treatment (MAT) for opioid addiction:
- Methadone: A long-acting opioid medication that can help manage withdrawal symptoms and cravings. It is taken daily in a controlled setting, such as a clinic.
- Buprenorphine: A partial opioid agonist that can also help manage withdrawal symptoms and cravings. It can be prescribed in a doctor’s office and taken at home.
- Naltrexone: A medication that blocks the effects of opioids and can help prevent relapse. It is taken as a daily pill or a monthly injection.
- Suboxone: A combination of buprenorphine and naloxone, which can help manage withdrawal symptoms and cravings and also prevent misuse. It is prescribed by a doctor and taken at home.
Inpatient treatment
You can find detoxification facilities through the Treatment Locator from the Substance Abuse and Mental Health Services Administration (SAMHSA).
Individual and group therapy
One effective way to address morphine misuse is to work with a therapist who is trained in cognitive-behavioral therapy (CBT). CBT can help you gain insight into your thinking patterns and the behaviors that contribute to morphine misuse.
If one-on-one counseling isn’t accessible to you, you may wish to consider a local support group, such as:
Let’s recap
Morphine use disorder, also known as morphine addiction, can affect anyone. Regardless of how someone is feeling, there is help and support available.
According to Schiff, all addictions can be overcome, even if they have become severe.
It may aid your recovery to keep learning about addiction. Here are some books you may find useful:
- “Overcoming Opioid Addiction” by Adam Bisaga, MD
- “In the Realm of Hungry Ghosts” by Gabor Maté, MD
- “It Works, How and Why: The Twelve Steps and Twelve Traditions of Narcotics Anonymous” by Narcotics Anonymous
“I recommend the TED Talk by Johann Hari,” Schiff says. “I also like the work of Dax Shepard and Russell Brand, who are both very open about their recovery from addictions.”
If you’re willing to take the first step, recovery from morphine use disorder is possible — one day at a time.
Here are some additional resources to take the next step:
- American Psychiatric Association’s Find a Psychiatrist tool
- American Psychological Association’s Psychologist Locator tool
- Asian Mental Health Collective’s therapist directory
- Association of Black Psychologists’ Find a Therapist tool
- National Alliance on Mental Illness helplines and support tools
- National Institute of Mental Health’s helpline directory
- National Queer and Trans Therapists of Color Network
- Inclusive Therapists
9 sources
- Azadfard M, et al. (2021). Opioid addiction.
ncbi.nlm.nih.gov/books/NBK448203 - Chervenak J. (2021). Personal interview.
- Dydyk AM, et al. (2020). Opioid use disorder.
ncbi.nlm.nih.gov/books/NBK553166/ - Morphine: Drug fact sheet. (2020).
dea.gov/sites/default/files/2020-06/Morphine-2020.pdf - Opioid overdose crisis. (2021).
drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis - Opioid use disorder. (2018).
psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder - Prescription opioids DrugFacts. (2021).
drugabuse.gov/publications/drugfacts/prescription-opioids - Regusters T. (2021). Personal interview.
- Schiff H. (2021). Personal interview.