Thursday October 23rd 2014

What is morphine withdrawal?

Daily users of morphine can develop a physical dependence on morphine after just a couple of weeks of regular dosing. Physical dependence causes withdrawal symptoms to manifest when you significantly lower doses or stop taking morphine completely.

Morphine withdrawal by itself may not be life threatening, but the drug is addictive and can negatively impact all areas of your life. However, treatments for morphine addiction can help you withdraw and abstain. Here, we take a look at the symptoms of morphine withdrawal and offer advice on how to navigate and cope with the difficult phase of withdrawal. Then, we invite your questions about morphine withdrawal or how to help morphine addiction at the end.

What is morphine withdrawal syndrome?

Morphine is an opiate analgesic drug prescribed for acute chronic pain and in some cases may be prescribed for opiate substitution therapy. Morphine can be highly addictive, and physical and psychological dependence are expected outcomes of regular dosing. Users also develop a tolerance for the drug – which means that the longer they use morphine, the more of it they need to produce the same effects.

Morphine withdrawal occurs because the brain adapts to the presence of the drug and becomes used to it. When the user stops using the drug, the brain recognizes its absence and compensates by acting in a way that gives rise to morphine’s withdrawal symptoms.

What is withdrawal from morphine like?

Morphine withdrawal is like having an awful flu. Stopping use of morphine causes classic withdrawal symptoms, also referred to as prototypical opioid withdrawal syndrome. These include physical symptoms such as tremors, cramps, flu like symptoms (sneezing, runny nose, chills etc), diarrhea, vomiting, perspiration, musculoskeletal pain and physical weakness and restlessness. Psychological symptoms of morphine withdrawal include cravings, anxiety, depression, paranoia, insomnia and a general feeling of being unwell.

What does morphine withdrawal feel like?

Typically morphine withdrawal begins about 6 to 14 hours after the last dose. You may feel a craving for the drug, anxiety, irritability and may be sweating. Some hours later, you may feel sleepy and could have intensification of the initial symptoms. Flu like symptoms may follow along with muscle twitches, chills, hot flashes, fever, nausea, abdominal cramping, musculoskeletal pain, and diarrhea. During acute withdrawal, there could be heart beat acceleration, which could contribute to the possibility of heart attack or stroke. There is also greater susceptibility to infection during the withdrawal period.

The physical withdrawal symptoms of morphine could last for several days. However the psychological symptoms (evidence of addiction) may be longer lasting and more complex. Craving, compulsion, and obesession to use morphine can persist for weeks or months after cessation of use. Severe insomnia, depression, mood swings, memory problems, confusion, paranoia, low self esteem and psychological disorders can also stem from morphine withdrawal.

What helps morphine withdrawal?

A multi faceted approach to morphine withdrawal should encompasses supportive care and medications to help address symptoms during acute detox.

Detox – Voluntary supervised medical withdrawal is recommended for people severely dependent on morphine or when morphine addiction is present. A user can get admitted to a residential (inpatient) facility or can undergo detox as an outpatient at an addiction center. Drugs and counseling may be a part of this phase of treatment.

Home remedies – Self help and home remedies to get through the withdrawal phase will help manage symptoms and may prevent relapse. For example, morphine withdrawal can cause cramping, body ache, musculoskeletal pain and flu like symptoms. Over the counter medications for flu, ibuprofen and Tylenol and steam inhalation can help bring relief. Heating pads and warm baths can also help reduce physical discomfort. Nausea, vomiting and runny stools can be controlled with the help of medications such as Loperamide (Imodium). It is important to take in plenty of fluids to prevent dehydration because sweating is usually a part of morphine withdrawal which can result in significant water loss.

Medications – Morphine withdrawal can be treated with many kinds of medications for opioid withdrawal . Clonidine can help control feelings of anxiety, cramping and flu like symptoms. Buprenorphine (Subutex or Subozone) is effective for easing and shortening the duration of detox. Methadone maintenance treatment may also be used to block the euphoric effects of the opioid.

Social support and psychotherapy – Drug cravings will typically follow cessation of morphine use. This is natural and a part of the recovery process. Joining a support group (in your locality or even online) can help you feel less isolated and helpless. Sharing your problems with a psychologist, psychiatrist, or sober friend or joining self-help groups like Narcotics Anonymous or SMART Recovery can put you on the track to lasting recovery.

Tapering – Structured opioid therapy under the direction of an experienced addiction specialist can help during withdrawal from morphine. Gradual tapering of the drug is recommended as against abrupt cessation because the latter can result in acute withdrawal and may trigger reuse rather than support lasting recovery. Safe and effective tapering could mean that the user doesn’t need methadone or buprenorphine maintenance treatment. In most cases a 2 to 3 week tapering regimen can be quite effective. General guidelines include:

• Reduce the each daily dose by 10%

• Reduce the dose by 20% every 3-5 days

• Reduce the dose by 25% per week

• Avoid reducing the daily dose by more than 50% at any given interval

The tapering should be closely monitored by the attending addiction specialist by way of observation and urine testing for drugs. It is also important to remember that after some weeks of abstinence the body loses its tolerance to the drug so that previously tolerated doses may actually be an overdose for the user.

Questions about morphine withdrawal

Do you still have questions about morphine withdrawak? If you or anyone close to you has become addicted to morphine you may have several questions about morphine addiction, dependence, its withdrawal symptoms and treatment protocols. We encourage you to ask questions and share any of your experiences on the subject and become a part of the dialogue via the comment form below. We will get back to you personally and promptly.

Reference Sources: NCBI: Neurotransmitter mechanisms of morphine withdrawal syndrome
NCBI: Impact on Immune cell function during morphine withdrawal
Medlineplus: Opiate withdrawal
SAMHSA: Detox for substance abuse
WPPNT: Opioid update
NCBI: Opiate withdrawal
CPSO: When and how to taper opioids
SAMHSA: Recommendations for tapering off opioids

Photo credit: redwolf518stock

Leave a Reply

2 Responses to “What is morphine withdrawal?
garry schrier
7:44 pm June 21st, 2014

I have been on 100 m pills twice aday fot 15 years or so. What can I do to get off of this drug.

8:47 am June 24th, 2014

Hello Garry. Speak with your prescribing doctor to set up a tapering schedule. Because of the length of use, you may want to ask for an extended taper, of 4-6 weeks, or longer. the idea is that you slowly lower morphine doses to minimize the severity of symptoms, and then stop taking it completely. You can possibly replace morphine with another opioid medication such as buprenorphine or methadone or even tramadol to minimize withdrawal symptoms, but you meed medical supervision and advise during the entire process. Best of luck to you!