ARTICLE OVERVIEW: Morphine withdrawal is safest when performed under medical supervision using tapering protocols and medications. We review the safe ways to quit using morphine here and explain the consequences of quitting morphine abruptly.
TABLE OF CONTENTS
- Predictable Effects
- What Withdrawal Is
- The Withdrawal Timeline
- Can I Just Quit?
- Do I Have a Drug Problem?
- How Do I Stop?
- Medical Detox
- Tapering Guidelines
- Detox at Home
- Cold Turkey
- Where to Go for Help
Morphine is a powerful opioid used to treat moderate to severe pain. It works by targeting the central nervous system directly, binding to brain receptors and changing the neurochemical activity within nerve synapses. In effect, it bring about pain relief by changing our perception of the pain.
However, there are predictable effects that occur when you take morphine daily for longer than a few weeks, or so. One effect is dependence. The other effect is tolerance.
Drug dependence is a chemical adaptation to a psychoactive drug like morphine in the brain. It is characterized by the appearance of withdrawal symptoms upon significant dose lowering or dose cessation.
Drug tolerance occurs at different stages for different people. It is characterized by a “dulling” of effect and manifests as the need for increasing doses or frequency of dosing in order to achieve the same initial effect.
Additionally, morphine is a highly addictive drug. Some people use morphine not only for managing their pain, but to feel better or to get high. According to 2011 HHS study, daily morphine use can cause regional neuroplastic changes in the human brain after only one month of daily administration. When abused, morphine can be a very difficult habit to quit…yet not impossible.
Are you worried for using morphine too long? Continue reading to learn more about help for quiting morphine. At the end, we invite you to post your questions or your personal experiences about getting off morphine. We try to respond to all real life situations with a personal reply.
What Withdrawal Is
When you stop taking morphine after a period of regular, daily dosing … expect to go through withdrawal. Withdrawal happens as a direct result of physical dependence on a drug. So, how did your body adapt to morphine so much that it rebels when you want to quit?
When you take a psychoactive drug like morphine over a period of weeks or months, your body seeks a way to live with it. It adapts chemically so that it can survive. This is why some functions of the brain and body “slow down” while others “speed up”. It’s the body’s way of seeking balance; it wants to compensate for the chemical reactions that are doping up the brain. Remove the drug…and those same processes (“slow down” and “speed up”) require time to balance out.
Physical dependence on morphine manifests as a set of symptoms when you quit. They are actually the “sped up” functions that morphine had been balancing out. Most people face a range of cognitive and physical symptoms. Withdrawal symptoms usually occur when a dependent user stops taking morphine completely or lower dose(s) significantly. Common symptoms that occur during morphine withdrawal include:
- Watery eyes
The Morphine Withdrawal Timeline
Moreover, morphine withdrawal has several stages. Each stage is characterized by different symptoms, or various levels of intensity of the symptoms.
The FIRST STAGE. The first symptoms of withdrawal usually occurs 6 – 14 hours after last dose. During this stage individuals usually experience:
- Drug cravings
- Mild to moderate depression
The SECOND STAGE occurs 14 – 18 hours after the last dose and is typically accompanied by:
- Heavy perspiration
- Runny nose
The THIRD STAGE is expected within 16 – 24 hours after the last dose administration and is followed by:
- Aching bones and muscles
- Dilated pupils
- Hot and cold flashes
- Loss of appetite
- Muscle twitches
The FORTH STAGE –occurs about 2 days after the last taken dose of morphine and includes:
- Elevation of blood pressure
- Increase respiration and tidal volume
- Loose stool
- Moderate elevation in body temperature
- Severe cramping
The FIFTH STAGE. This stage appears 36 – 72 hours since the last dose of morphine. The symptoms that you can expect during the fifth stage include:
- Frequent liquid diarrhea
- Increased white cell count and other blood changes
- Weight loss of 2 to 5 kg per 24 hours
The SIXTH STAGE. This stage of withdrawal manifests after you have successfully completed the previous five stages. During this period, you’ll start to deal with psychological symptoms of his/her addiction. This stage also includes the following symptoms:
- Colitis or other GI afflictions related to motility
- Increased sensitivity to pain
- Normalization of food appetite
- Problems with weight control
- Stabilization in bowel function
Can I Just Quit?
NO. It is not recommended that anyone go cold turkey off of morphine. Morphine detox is most successful when performed under doctor’s care. Further, medically supervised morphine detox can prevent dangerous withdrawal effects.
People who usually stop taking morphine on their own experience intense and unpleasant symptoms, which can discourage them from staying off morphine for good. Individuals who quit using morphine without the help of a doctor also have a higher risk of relapse and failure to reach long-term sobriety. Thus, it’s suggested that you seek help from a medical detox clinic when you decide to stop taking morphine… for safety AND efficacy.
Do I Have a Drug Problem?
To get clean and start over, you need to be honest with yourself about your morphine use. Start that by answering these questions:
- Do you use morphine to get high?
- Do you think about morphine constantly?
- Are you using morphine to hide your emotional and/or mental problems?
- Is taking morphine affecting your home, social, school, or work life?
- Do you often find excuses for use?
- Do you lie about your use?
If many answers are ‘yes’, it might be the right time to take a medical assessment for opioid dependence and addiction. Also, consult with a certified addiction professional to diagnose the severity of your addiction.
Being a highly-addictive medication, morphine use can lead directly to addiction. Even if it starts as a prescription. There is no enough place for guilt and shame in admitting that you have a problem. You are not alone!
In fact, the 2016 National Survey on Drug Use and Health reported that:
- 6.8 million Americans used morphine in the past year.
- 536,000 people misused of morphine in the past year.
Moreover, the American Society of Addiction Medicine claimed that in 2016 about 2 million Americans had a substance use disorder that involved a prescription painkiller.
Still think that you are alone?
Call us. We’re here to help.
How Do I Stop?
First, we recommend that you consider a medical detox. More details on the services and medications provided in such as setting are explained below. However, stopping morphine should not include drug detox only. It can also require physical, psychological, and emotional rehabilitation.
So, to stop morphine for good, you may need to go to a 30-60-90 day rehab. In these cases, 100% devotion to treatment can help you to successfully treat and recover from morphine addiction.
Structured rehabs provide doctors, counselors and therapists who assist you in the recovery process. During treatment, people have the chance to work on different aspects of a morphine addiction, which can be physical, mental, and even spiritual in nature. Individuals who go through a structured rehab program are invited to discover personal root causes for addictive behavior, work to resolve them, and reach sobriety over the long-term.
Morphine can be difficult to quit, but medical help makes the process of detoxification more humane. If you choose to go to a medical detox, you can expect these steps:
The first step is assessment and filling-up paper work. Also, you may be asked to take a drug test or undergo a physical exam. Often, you’ll be required to go through an interview process. Also expect to submit insurance or payment information. This stage will help clinicians to create your therapy plan.
During this step, medical staff will examine your physical, as well as psychological state. Also, if there is a need for medications that will help you manage withdrawal, nurses will obtain prescription from licensed physician.
3. Tapering Protocols
Tapering protocols are different for each patient, and they are completed according to doctor’s orders. Doses are generally not reduced by more than 25% in one week. This is the time when you go through withdrawal. So, be prepared!
4. Transfer to Treatment
Medical detox is just the first stage of ending a drug problem. Once the drug is out of your system, you may need to learn how to live life without drugs. Treatment helps people stay sober, and maintain their sobriety. Taking this step is up to you. No one can force you go into rehab.
Doctors suggest following a tapering schedule and taking other medications to assist in the process. Your tapering schedule should be created along with your doctor, and with based on your health state, duration of morphine use, and your dose of morphine. Usually individuals require about 2 to 3 weeks to successfully taper doses down. Some general guidelines used in a morphine taper are:
- 10% reduction in doses a day.
- 20% reduction in doses every 3-5 days.
- 25% reduction in doses per week.
- Avoiding more than 50% reduction off the daily dose at any given interval.
You may find more specific tapering guidelines for morphine here:
- CDC Guideline for Prescribing Opioids for Chronic Pain
- Washington State Opioid Taper Plan Calculator
Many medications are used to minimize the intensity of withdrawal. The World Health Organization stated that buprenorphine and methadone are key medicines if you want to have a successful opioid addiction treatment. Below is a list of the most commonly used medicines during a medical detox from morphine:
1. Antidepressants. Everyone who experience detox should be evaluated for mental health issues. In those cases, SSRIs or trazodone can help immensely.
2. Medicines that postpone withdrawal. Buprenorphine and methadone are widely used as replacement therapy, and to make detox less severe.
3. Medicines that prevent relapse. Naltrexone blunts the brain receptors that are affected by morphine. It is mostly used in combination with buprenorphine or methadone.
4. Medicines that treat certain symptoms as they occur.
- Clonidine- treats anxiety, agitation, muscle pain, sweating, and runny nose.
- Dicyclomine hydrochloride – treats abdominal cramps.
- Diphenoxylate and Loperamide – treat diarrhea.
- Hydroxyzine and Promethazine – prevent or reduce nausea and vomiting.
- Methocarbamol – treat joint pain and muscle cramps.
NOTE: Replacement therapy with opioids like methadone or buprenorphine may switch one addiction to another. Be careful with this one!
It is possible to detox at home, but it may be risky. You may need 24/7 medical supervision where doctors and nurses can offer medications to ease withdrawal symptoms. Moreover, if you detox at home you do not have access to medical staff who can offer emotional and psychological support that will prevent relapse.
If you choose to detox at home, this requires permission and a tapering schedule from your prescribing doctor. This is important because mophine home detox is not for everyone. People who have severe addiction, certain medical condition, and/ or poor general health may not be eligible for this type of detox.
Doctors advise against going off morphine cold turkey. Due to the drug’s highly addictive properties, suddenly stopping morphine can cause severe withdrawal symptoms and provoke relapse. Going cold turkey off morphine might be very dangerous for people who have lung and heart problems. Another danger of stopping morphine abruptly is the intense experience of acute withdrawal symptoms.
An alternative for sudden discontinuation is a slow morphine taper. Talk to a medical professional, or look for a morphine addiction treatment facility for supervision. This will increase your chances of successful recovery.
The safest way to stop morphine is to seek morphine detox under medical supervision. A medical detox clinic can offer 24-7 medical supervision. Detox clinic staff help you by advising you, prescribing medications, assist your detox and withdrawal, and work with you resolving your psychological and behavioral issues. There is also an element of emotional support you can get at a detox center that may not be available at home.
If possible, round up the motivation and support coming from your family and friends. Long term recovery from a morphine problem requires help from multiple sources. And, stay committed to your recovery after leaving rehab by joining a support group, such as 12-step support groups. Some people stay in psychotherapy for a year or two after they quit using.
Where to Go for Help
Dealing with substance use disorder is a serious condition that may ruin your whole life. The sooner you admit that you have a problem, the better. This is not the time you to act like a hero, and do everything by yourself. This is the time to seek help. The main places to find addiction specialized services include:
- Addiction rehabs
- Licensed psychologists
- Licensed psychiatrists
- Medical detox clinics
- Medical doctors
If you are addicted to morphine, a rehab program can help you uncover all underlying issues to your problems. The are two types of rehab programs: inpatient and outpatient.
Inpatient programs offers constant medical care and supervision. Patients live in the facility during the whole program. The most common services provided include:
- Individual counseling therapy
- Group therapy
- Educational classes about addiction and recovery
- Medication management
- Regular routine establishment
Outpatient programs provide similar counseling services that use both individual and group therapy, but there is no constant medical care since patients don’t live in the facility. Instead, people come and go for a few hours several days per week. This treatment is more flexible because it allows patients to continue with their daily responsibilities to home, work, or school.
Whether you are having problems with using morphine, or not, you deserve a substance-free life. But, you may not be able to quit it on your own. Using morphine for a longer period of time can cause dependence or even addiction.
So, are you ready to quit morphine for good?
If yes, then make sure to have these three supports:
1. Willingness to change. If you want to turn your life around, and start over, you really need to want it, and have the motivation to keep your going.
2. Medical resources. Get all education and medical resources that you need by contacting your prescribing doctor, a pharmacist, or medical detox staff. They will help you anytime.
3. Emotional support. Your family and friends need to be supportive of your change, and respect your choices. If people around you are not supportive, your recovery path will be more difficult.
Got Any Questions?
Still have questions about how you can quit morphine successfully and in a safe manner? We invite you to post them in the designated section below. We try to reply personally and promptly to all legitimate inquiries. In case we don’t know the answer to your question, we will refer you to someone who can help.