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Morphine Withdrawal

Morphine is one of the most common opioid pain relievers in the world. It was among the first widely used opioids in the United States, and it was frequently used as a combat medication through the wars of the late 19th and 20th centuries. 

Morphine is still used today, and it’s an effective pain reliever for many patients. However, it can also create dependence and addiction in those who use it. After the U.S. Civil War, when soldiers used the drug extensively, it is reported to have caused thousands of cases of morphine addiction after 10 million pills were given to soldiers. 

Morphine works similarly to other opioids. It binds to opioid receptors in the brain that normally bind with the body’s own natural opioids, which are called endorphins. Endorphins are very similar to morphine and get their name by combining “endogenous morphine.” They are designed to regulate the body’s pain response. It binds to receptors all over the body and blocks pain signals from being sent and received by neurons.

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However, moderate-to-severe pain can be too much for your endorphins to handle, so you continue to feel pain. This is your body’s way of telling you that there’s something really wrong. However, when you are under medical care, you’ve been treated, and now you just need to recover. Pain is more of a hindrance than a help. Morphine can bind to your opioid receptors and activate them, causing more powerful feelings of pain relief and euphoria than your endorphins.

The drug is so potent that your body may start to rely on it. After a long period of regular use, or high doses, your body will begin to develop a chemical dependency. That means your brain may start to alter and adapt brain chemistry to try to balance your neurochemistry. If you stop using the drug, your brain chemistry will become unbalanced, and this can bring on uncomfortable withdrawal symptoms. Learn more about morphine withdrawal and how it can be safely treated.

What Are Morphine Withdrawal Symptoms?

Like most opioids, morphine withdrawal symptoms are said to mimic symptoms of the flu. These symptoms can be intense and maybe more like the worst flu you’ve ever experienced. Along with intense flu-like symptoms, you’ll also experience uncomfortable compulsions to use morphine again, which can be difficult to resist without help. Other symptoms can include:

  • Runny nose
  • Sweating
  • Yawning
  • Watery eyes
  • Chills
  • Body aches
  • Anxiety
  • Nausea
  • Vomiting
  • Diarrhea
  • Insomnia
  • High blood pressure
  • Increased heart rate

What Are the Stages of Morphine Withdrawal Timeline?

The timeline on which you experience morphine withdrawal can vary based on your personal experience with the drug. How long have you been using it? How long have you been dependent? How high is your regular dose? How high was your last dose? All of these considerations can affect your withdrawal timeline and the severity of your symptoms.

Generally, using higher doses of morphine for longer periods will result in experiencing more severe symptoms more quickly. Though your timeline might be unique, it’s likely to be similar to the following:

  • 12 hours: You will likely feel your first morphine withdrawal symptoms within 12 hours. Morphine has a half-life of three hours, so you may start to feel your first symptoms as early as five to six hours as the drug wears off. Early symptoms can include early flu-like symptoms like fatigue, runny nose, and body aches.
  • Three days: Symptoms will get worse over the next few days until they peak around the third day. Peak symptoms are when the withdrawal period is at its worst. It can include severe flu-like symptoms, like nausea, vomiting, and diarrhea. You may also experience intense drug cravings. 
  • Seven days: After your symptoms peak, they will start to dissipate over the next few days. The most intense physical symptoms like vomiting and nausea are usually the first to go. Psychological symptoms like anxiety, depression, and insomnia may linger. Cravings may still be intense. 
  • 1 month: Your acute withdrawal symptoms may end after 10 days, but symptoms like irritability and anxiety may continue. Cravings may also come and go. Some of them will be difficult to resist. Lingering symptoms may need to be addressed in treatment to avoid relapse. 

Why Should I Detox?

Opioids like morphine don’t typically cause life-threatening symptoms, but they can cause intensely unpleasant flu-like symptoms. Opioid withdrawal is extremely difficult to get through without using the drug to ease your cravings and symptoms.

Medical detox is the highest level of care in addiction treatment, according to the American Society of Addiction Medicine. It involves 24-hour treatment from medical professionals that are experienced with withdrawal treatment. Detox can also treat medical conditions that have to be addressed alongside withdrawal. Detox typically lasts between a week and 10 days.

What Is the Next Treatment Step?

When you enter addiction treatment, you will go through a medical and clinical assessment process that’s designed to determine the level of care that’s appropriate for your needs. According to the National Institute on Drug Abuse (NIDA), detox is an important part of addiction treatment, but it’s not all you need to treat addiction.

To effectively address a moderate-to-severe substance use disorder, you may need to go through additional levels of care. If you still have high-level medical or psychological needs, you may need to go through an inpatient or residential treatment program. If you can safely live on your own, you may go through an outpatient program, with between one and 20-plus hours of weekly participation, depending on your needs.

Sources

ASAM. (2018, July 20). What are the ASAM Levels of Care? from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/

National Institute on Drug Abuse. (n.d.). Opioids. from https://www.drugabuse.gov/drugs-abuse/opioids

National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

Trickey, E. (2018, January 4). Inside the Story of America's 19th-Century Opiate Addiction. from https://www.smithsonianmag.com/history/inside-story-americas-19th-century-opiate-addiction-180967673/

U.S. National Library of Medicine. (2019, October 1). Morphine: MedlinePlus Drug Information. from https://medlineplus.gov/druginfo/meds/a682133.html

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