Morphine and the Start of Opioid Analgesic Medications
Morphine is a natural opiate analgesic that was first discovered and isolated from opium around 1804 by a German chemist named Freidrich Wilhelm Adam Serturner. Opium in turn is obtained from the seedpod of the poppy plant. At the time, the 21 year-old Serturner was working as a pharmacist’s assistant and was curious to find out more about the medicinal properties of opium which was widely used at the time. He performed a series of experiments in which he isolated an organic alkaloid compound from opium. He then found that opium without the alkaloid compound did not have an effect on animals, but that the compound itself was 10 times as powerful as processed opium. Serturner named the compound morphine, after Morpheus, the Greek god of dreams, for its sleep-inducing effect.
Serturner's crystallization of morphine was the first isolation of a natural plant alkaloid. It sparked the study of alkaloid chemistry and hastened the emergence of the modern pharmaceutical industry. In 1818, French physician Francois Magendie published a paper that described how morphine brought pain relief and much-needed sleep to an ailing young girl. This stimulated widespread medical interest. By the mid-1820s morphine was widely available in Western Europe in standardized doses from several sources, including the Darmstadt chemical company started by Heinrich Emanuel Merck.
By the 1850s the first reliable syringes were developed and injected morphine became a standard method of reducing pain during and after surgery. Since then, various delivery systems for morphine have been developed, including epidural injections and pumps that allow patient-controlled analgesia.
Although morphine was originally touted as a cure for many maladies, even for opium addiction, by the 1870s physicians had become increasingly aware of its own addictive properties.
Today, morphine is the fourth most misused prescription opioid in the US with over 500,000 million Americans misusing it in 2017.
What is Morphine?
Morphine is a prescription opiate analgesic used to treat moderate to severe pain. In the two hundred or so years since it was discovered, its use has only increased, and it remains a gold standard in pain management. The term “morphine equivalent units” is the standard measure of potency or strength in the industry.
FDA-approved generic versions are widely available as are the branded products including:
- Arymo ER
- MS Contin
Is Morphine an Opiate or Opioid?
The distinction between an opiate versus an opioid is based on whether it is made from natural (opiate) or synthetic (opioid) ingredients. Morphine is obtained from the opium poppy plant’s seedpod and hence is a natural opiate. In fact, it is the first natural opiate analgesic that paved the way for other natural opiates like codeine and then the semi-synthetic opioids like heroin and the synthetic versions like fentanyl. The terms opiate and opioid are currently used interchangeably and generally opiates are classified as a sub-group of opioids which includes natural, semi-synthetic, and synthetic products.
Morphine Side Effects
Common side effects include:
- Abdominal pain
It is important to take this medication exactly as prescribed by a physician to avoid side effects and potential overdose. Misuse and abuse of this medication can lead to serious health effects as well as substance dependence and addiction. Taking morphine for longer than prescribed or at higher doses than recommended can lead to tolerance of the drug, which means that a person needs more of the drug to achieve the same pain-relieving effect.
If any side effects persist or another more serious one such as a seizure is experienced, it is important to call your doctor and/or go to the emergency room immediately.
Even two hundred years ago as morphine was experimented with, its addictive effects were recognized and documented.
Morphine can be highly addictive, and recently the FDA instituted an Opioid REMS program in September, 2018 that required the inclusion of safety information about the risks of misuse, abuse, addiction, overdose, death, and slowed or difficult breathing in a “black box warning” on the consumer drug labels for these products for the short-acting immediate release versions of all FDA-approved opioid analgesics not just morphine. (Extended release / long acting (ER/LA) versions have been subject to a REMS and black box warning since 2012.)
Morphine Withdrawal Symptoms
Some or all of the following can occur:
- Lacrimation (tearing)
- Rinorrhea (runny nose)
- Myalgia (muscle pain)
- Mydriasis (dilated pupils)
Other signs and symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.
It is best to have medical supervision with morphine withdrawal because it is very unpleasant and there is a high risk of relapse during detox. Physical withdrawal symptoms last for approximately one week but can be prolonged over several weeks/months if you have been taking the drug for a long period of time or in high amounts.
Withdrawal symptoms can be eased by undergoing a medically assisted tapering off regime designed by your doctor. A SAMHSA certified opioid treatment program is recommended.
How Long Does Morphine Stay in Your System
The length of time morphine stays in your system varies from person to person and is dependent on several personal factors. Body fat percentage, metabolism and other medications can all affect the rate that your body dispels this drug.
Morphine sulfate injections has a half-life generally accepted to be 1.5 - 2 hours. The time the remaining half can be detected in your system falls within the following time frames, to be used as a broad guideline only:
- Urine: 1-3 days
- Saliva: 12 -24 hours
- Blood: 12 to 24 hours
- Sweat: 1 to 4 weeks
- Hair: 4 to 6 months