Morphine

MAIN TYPE

Morphine belongs to the category of drugs called narcotics. It is an opiate, which comes from the poppy just like opium. Morphine is synthesized from raw opium. It is mainly used in a medical setting to treat pain, especially after surgery or during palliative care of the terminally ill.

Morphine is marketed in pill or syrup form. It can also be injected into the bloodstream or administered as a suppository. Illicit users can inject, swallow or smoke morphine. It is often used by heroin addicts as an alternative drug because of its potency and similar effects. Morphine sulfate looks like a white powder. It is soluble in water and partially soluble in alcohol.

Like other opioids, morphine works by binding to opioid receptors in the brain, digestive tract and spine, which changes the way the body processes pain.

Morphine was isolated from raw opium in 1804 by German chemist Friedrich Sertürner, who chose the name after the Greek god of dreams, Morpheus. With the invention of the hypodermic needle in 1853, the use of morphine became more widespread as it could now be administered in precise doses. Morphine was soon preferred to opium for pain relief and was massively administered to wounded troops during the American Civil War. By the end of that war, more than 40,000 soldiers had become addicted to morphine. Similarly, in Europe, the Franco-Prussian War is said to have addicted hundreds of thousands of soldiers. In America, the use of morphine was banned in 1914, except when prescribed by a doctor.

This drug is the most powerful of all opioids and is highly addictive. Even if a physical dependence can take several months to develop, psychological dependence can appear after only a few doses because the drug is so powerful and effective in relieving pain and providing a state of euphoria to the user.

OTHER TYPES

On the street, morphine is mainly used as a substitute for heroin. It can be in the form of white pills to be swallowed and called “white lady”. These pills can also be ground into a fine white powder to be inhaled, dissolved in water or alcohol and then drunk or injected as a solution. This powder is sometimes called “salt” or “sugar”.

To play on the first letter of the word, morphine has been nicknamed “Emma” (also “Aunt Emma”, “Miss Emma”, “Emsell” and variations of these names including “Missy”, “Auntie” and “Em”).

She is also known as “Mister Blue”, “China White”, “Morph”, “White Stuff”, “Morpho”, “Dreamer”, “Unkie”, “God’s drug” and “Pectoral Syrup”.

MAIN EFFECTS

Morphine, like other opioids such as raw opium and heroin, acts on the opiate receptors of the central nervous system. Taking morphine initially induces a feeling of euphoria. It suppresses any pain the user is feeling, releases anxiety, suppresses hunger and also makes the user sleepy. When a person takes morphine, their breathing becomes more shallow. Therefore, if the dose is too high, the drug can severely weaken the respiratory system and lead to coma or death.

Morphine also suppresses the cough reflex. It can cause constipation and low libido. Finally, it can alter the menstrual cycle of women.

Long-term use of morphine can create a tolerance to the drug, forcing users to take higher and higher doses to get the same effect. In addition, morphine is addictive, both psychologically and physically.

This is due in part to the withdrawal effects that occur when the drug is stopped. Withdrawal can cause severe nausea, vomiting, uncontrollable crying, involuntary yawning, and severe chills and cold sweats. The most acute symptoms can last up to three days.

If a pregnant woman takes morphine, she will pass the drug to her baby through the placenta and the baby will also suffer withdrawal effects at birth.

Long-term use of morphine can alter the immune system, making the user more vulnerable to infection.

PRODUCING COUNTRIES

In 2010, the world’s largest producer of morphine was the United Kingdom, with 97.4 tons of the drug. This figure represents 23% of the total production of morphine in the world. The United States came second, with 78.4tonnes (19% of world production). Then came France, with 67.9 tons or 16% of world production, and Australia with 41.2 tons or 10% of world production. Finally, the fifth largest producer of morphine was Iran, with 23.4tonnes, representing 6% of world production.

Together, these five nations accounted for 74% of global morphine production, showing that the vast majority of the drug is manufactured in the influential industrialized regions of North America, Europe and Australasia.

Figures for 2010 show that four other countries each contributed more than 10tonnes of global morphine production. These are China (18.5 tons), Japan (12.5 tons), Slovakia (11.5 tons) and Hungary (10.5 tons).

Between 1990 and 2010, morphine production and consumption increased worldwide.

The United States consumed about 55% of the world total, Europe about 27%, Canada just over 4% and Australia and New Zealand just under 3%.

Morphine producing countries export the drug to all corners of the world. The total quantity exported in 2010 was around 25tonnes, the main exporter being the UK, with 33% of the total. In the same year, Slovakia exported 17% of the total.

In terms of imports, seven countries imported more than one ton of morphine: the United Kingdom, Brazil, Germany, France, Austria, Canada and Hungary. Of these countries, France was the largest importer, with 4.4 tons, followed closely by Germany, with 4.3 tons.

Although in terms of commercial sales, morphine is a relatively affordable drug, access to it is limited in several developing countries. In 2005, six countries (the United States, Canada, Australia, the United Kingdom, Germany and France) alone were responsible for 79% of total morphine consumption, while the poorest countries, which represent 80% of the world’s population, consumed only 6% of the global total.

In the countries of production, morphine is classified in different ways. In the United Kingdom, it is considered a Class A drug under the Misuse of Drugs Act. It is also a Schedule 2 controlled drug in a medical setting. In the United States, morphine is also considered a Schedule II drug, while in Canada it is a Schedule I drug. Finally, in Australia, morphine is considered a drug with therapeutic benefits and a potential for abuse, like cocaine and ketamine.

FACTS AND STATISTICS

FACTS

Morphine is the most powerful of all opiates. It is widely used in the medical community because of its great effectiveness in relieving pain, but it can be abused and have devastating psychological consequences. Here’s what you need to know about this drug:

• Like all opioids, morphine is extracted from poppy capsules.
• It is considered the most effective analgesic (or painkiller) by the medical profession.
• Morphine binds to opioid receptors in the intestines, spine and central nervous system.
• It is highly addictive, both physically and psychologically, particularly because the body develops a tolerance to the drug.
• Morphine is so effective at relieving pain that doctors believe its benefits outweigh the risks of addiction.
• Taking morphine produces a sense of euphoria, drowsiness, decreased anxiety and shallow breathing.
• This drug is widely used in hospitals after major surgery and to relieve the pain of terminally ill patients.
• An overdose of morphine can lead to respiratory depression, in which case breathing becomes so shallow that suffocation occurs.
• Morphine alters the perception of users.
  It suppresses appetite, causes constipation and lethargy.
• Sustained use can damage the users’ immune system.
• Morphine is often used by heroin addicts who have lost access to their drug.
• Withdrawal effects associated with morphine include nausea and vomiting, shaking, sweating, chills and uncontrollable crying.

STATISTICS

• Studies show that morphine is more addictive than many other drugs such as cannabis, cocaine, tobacco, alcohol, ecstasy and LSD.
• Morphine is one of the fifty or so chemical alkaloids present in raw opium. It represents between 8 and 17% of the dry weight of raw opium.
• Of all drug-related deaths in England and Wales between 2000 and 2004, opiates, including morphine, were responsible for 4978 of them.
• In the United States, approximately 10% of the population has abused an opiate, including morphine, at least once in their lifetime.
• According to a 1999 study, more than half of all accidental drug-related deaths were due to morphine or heroin.
• 88% of the world’s morphine production is extracted from “poppy straw”, which is the entire poppy plant harvested minus its mature seeds. The rest of the production comes from opium, which is extracted as dried poppy sap.
• In 2010, the United States, Australia, New Zealand, Japan, Canada, France, Germany and the United Kingdom accounted for over 93% of morphine consumption.
• In Australia, the number of people prescribed morphine for pain increased by 89% between 1995 and 2003.
• Statistically, people who inject morphine are most often unemployed and homeless men.
• Those who habitually inject heroin are more likely to inject other drugs and to have experienced physical problems related to intravenous injection. An Australian study found that 27% of people who used to inject morphine had experienced bruising or scarring, and 36% had difficulty finding a vein to inject.
• According to the same study, 38% of people who had recently injected morphine reported being addicted to the drug.

SIGNS OF ADDICTION

The most visible signs of a morphine addiction are those that occur due to withdrawal. These include sweating, shaking and vomiting. In addition, people suffering from morphine withdrawal effects may appear very anxious and feel pain.

Morphine addiction is also characterized by physical and behavioral changes in the user. A person who is under the influence of morphine may experience uncoordinated movement, extreme drowsiness, shallow breathing and muscle soreness, as well as loss of consciousness. Pupils will be abnormally small, the face will be flushed, and the thought process may seem abnormal and illogical. Finally, the user may be less sensitive to pain, have joint problems, roll his or her eyes involuntarily and have difficulty urinating.

Morphine causes water retention, so the user may show signs of swelling and impaction.

A person who injects morphine may have needle marks on his or her body, especially on the arms, ankles or behind the knees.

Morphine addiction can have a profound emotional effect on the user, who may appear anxious, depressed or irritable, and may feel excessive well-being or, on the contrary, a strong irrational fear. Morphine addicts are also prone to dreams and hallucinations.

Some people are allergic to morphine, in which case they may suffer from skin rashes, repeated sneezing and breathing difficulties.

Signs of a morphine overdose include limp limbs and muscles, cold or clammy skin, low heart rate and loss of consciousness.

TREATMENTS

Because morphine addiction is so strong, it almost always requires a professional treatment program, which may be administered at a detoxification center’s counseling or treatment department, depending on the severity of the addiction and other factors.

On the other hand, the withdrawal effects associated with morphine are so severe that withdrawal without professional support can have serious health consequences for the morphine addict.

Treatment involves first stopping the use of the drug. Morphine withdrawal, like other opioids, goes through several phases. The first phase, which occurs between 6 and 14 hours after the last dose, is characterized by cravings for the drug, irritability, anxiety, sweating and mild depression.

During the second phase, which takes place between 14 and 18 hours after the last dose, the morphine addict yawns, sweats profusely and cries. This is when the most severe depression occurs. Over the next 72 hours, the person may have a runny nose, goose bumps, cold or hot flashes, pain in the limbs, intestinal cramps, insomnia, rapid pulse, vomiting, diarrhea, involuntary ejaculation, rapid weight loss and increased sensitivity to pain. The most severe withdrawal effects occur between 48 and 96 hours after the last dose. They will subside within 8 to 12 days.

Treatment for morphine addiction must address both the physical and psychological dependence. It often includes therapy sessions to identify the root causes of the addiction and group therapy where morphine addicts share their experiences.

A change in physical environment as well as behavioral drivers are necessary to avoid relapse, which is common among morphine addicts. Users of opiates such as morphine and heroin have one of the highest relapse rates. Some health professionals estimate that this rate is 98% higher than that of people addicted to other drugs.

Outpatient detoxification programs for morphine addicts have been shown to be much less effective than inpatient programs, mainly due to the duration of the withdrawal effects. Morphine addicts often use another form of the drug, often with a prescription, to help them overcome symptoms. They often turn to antidepressants in an attempt to detoxify, which creates another addiction. This phenomenon is called “mixed addiction”.The best way for morphine addicts to break their addiction is to adopt a drug-free lifestyle.

Morphine addiction is insidious and can silently “infect” someone who has started using it legitimately to relieve pain. As a result, a morphine addict may be in denial. In this case, the person’s friends or family can organize an “intervention”, in which they share their experiences by explaining how the morphine addict’s addiction has affected them, which will help the person realize that he or she has a problem.

REFERENCES