Morphine Addiction: Symptoms, Signs, Effects, Causes, and Treatment Options

Developing a morphine dependency involves a multifaceted, ongoing disorder marked by the irresistible and unmanageable consumption of morphine, a pain-relieving opioid substance. This condition typically results in both bodily and mental reliance, where individuals suffer withdrawal manifestations when the drug is absent.

Indicators of morphine dependency include yearning for morphine, inability to regulate usage, fixation on securing morphine, withdrawal manifestations, emotional fluctuations, diminished enthusiasm for activities, seeking prescriptions from multiple physicians, and reduced physical and cognitive functioning.

The signs of morphine dependency are failed cessation attempts, shirking obligations, isolation from others, hazardous conduct, dishonest actions, slackened physique, nodding off or unconsciousness, whitish, cyanotic, or chilled skin, and constricted pupils.

The enduring consequences of morphine dependency include resistance and dependence development, persistent digestive slowness, breathing suppression, mental faculty deterioration, endocrine disruptions, and elevated overdose possibility.

The triggers for morphine dependency include medical directives, hereditary elements, psychological wellness conditions, communal and contextual influences, earlier substance misuse, and brain chemistry alterations.

The standard interventions for morphine dependency include physical detoxification, cognitive behavioral therapy (CBT), medication-supported recovery (MAT), communal therapy and peer networks, residential care, non-residential programs, concurrent diagnosis management, and household counseling.

What is Morphine addiction?

Morphine dependency is a grave and potentially life-changing condition that stems from the sustained and immoderate use of morphine, an opioid pain medication frequently utilized for discomfort management.

The World Health Organisation (WHO) defined the term "opioids" in the August 2023 issue, titled "Opioid overdose," as substances derived from the opium poppy plant (Papaver somniferum), that involve semisynthetic and synthetic compounds possessing similar characteristics, allowing them to interact with opioid receptors in the brain.

Morphine is named after Morpheus, the son of sleep and the god of dreams in Greek and Roman mythology, as claimed by Melissa Conrad Stöppler, MD, in the RxList medical dictionary section, titled "Definition of Morpheus". Being in Morpheus's arms means falling asleep. This association signifies the connection between the drug and the concept of entering a sleep or dream state induced by the drug.

Jahangir Moini et al. in their 2021 book, titled "Global Emergency of Mental Disorders," chapter "The opioid epidemic", defined morphine as an opiate pain reliever with a history spanning over 6000 years.

Morphine functions directly on the central nervous system to reduce pain perceptions. It is prescribed for both immediate and persistent pain and is administered orally, rectally, or through muscular, skin, and vein injections.

The pharmacological effects of morphine, as described by Listos J. et al. in the 2019 study, titled "The Mechanisms Involved in Morphine Addiction: An Overview," and published in the International Journal of Molecular Sciences, are linked to its ability to stimulate opioid receptors.

Among opioid medications, morphine stands out as an exceptionally potent analgesic regularly employed for surgical recovery and cancer-associated pain, though its extended application correlates with a considerable danger of misuse, as claimed by the study. This elevated risk of misuse becomes especially evident when examining the frequency of morphine dependency, addressed in the following paragraph.

Is morphine addictive? 

Yes, morphine is highly addictive. Morphine is a potent opioid that binds to mu-opioid receptors in the brain, triggering the release of dopamine and producing strong feelings of pain relief, euphoria, and sedation. These effects directly activate the brain’s reward system, reinforcing repeated use and increasing the risk of dependence and addiction over time.

According to a 2019 study by Listos et al., titled "The Mechanisms Involved in Morphine Addiction: An Overview", morphine addiction is driven by its stimulation of opioid receptors, which causes molecular changes within neurons, altering neurotransmission and promoting compulsive drug-seeking behavior. Another study by Suliman and Bakar, "Molecular Basis for Morphine Addiction", explains that long-term morphine use induces tolerance, dependence, and withdrawal symptoms, which are key markers of addiction.

Even when used under medical supervision, morphine can lead to physical and psychological dependence, particularly when taken for extended periods or in high doses. Because of this, it is classified as a Schedule II controlled substance in many countries, indicating a high potential for abuse and addiction.

How prevalent is Morphine addiction?

Morphine dependency is quite prevalent, considering the current statistics of opioid use disorder affecting over 16 million individuals globally and more than 2.1 million in the United States. This contributes to an annual toll of over 120,000 deaths attributed to opioids worldwide, as reported in StatPearls Publishing, titled "Opioid Use Disorder," updated in July 2023.

According to the June 2023 report "Drug Overdose Death Rates," from the National Institute on Drug Abuse (NIDA), the statistics on nationwide overdose deaths linked to prescription opioids, including morphine, exhibit a variable pattern spanning from 1999 to 2021. The number increased from 3,442 in 1999 to a peak of 17,029 in 2017, followed by a decline to 14,139 by 2019. A slight rise was observed in 2020 with 16,416 deaths, and in 2021, reported deaths involving prescription opioids totaled 16,706.

In view of these concerning figures on morphine dependency and the broader impact of opioid-related fatalities, recognizing the indicators of morphine dependency becomes essential for successful intervention and prevention strategies.

What are the symptoms of Morphine addiction?

The symptoms of morphine addiction are listed below.

• Intense urges to use Morphine
• Inability to manage usage
• Obsessive focus on obtaining the drug
• Onset of withdrawal symptoms
• Emotional instability
• Decline in interest in normal routines
• Seeking prescriptions from multiple providers
• Reduced cognitive and physical abilities

1. Intense urges to use Morphine

Yearning for morphine manifests as a powerful, consuming wish or impulse to utilize morphine. Brady M. Thompson et al. in their 2019 book, titled "Neural Mechanisms of Addiction," "Chapter 7- Interoceptive Stimulus Effects of Drugs of Abuse," defined drug craving as an internally perceived subjective state that may accelerate the initiation of drug use, particularly intensified in its absence.

This intense desire is prompted by numerous elements, including drug-related cues, along with internal conditions such as experienced stress or negative emotional states.

As stated in the 2016 "Neuroscience for Addiction Medicine: From Prevention to Rehabilitation – Methods and Interventions" book chapter titled "2.1 Drug Cue Reactivity (Positive Reinforcement)" and published in Progress in Brain Research, The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recognized drug craving as a key aspect of substance use disorders, acknowledging it as a motivational state that drives drug-seeking behavior.

Beyond drug-pursuit conduct, yearning for morphine fuels addictive patterns like persistent usage despite harmful outcomes, challenges in sustaining abstinence, and diminished self-restraint.

2. Inability to manage usage

Loss of control denotes a person's incapacity to supervise or restrict their consumption of substances, including morphine. Drug addiction is a chronic and recurring condition marked by an irresistible compulsion to pursue and consume the substance, inability to limit the quantity used, and the emergence of adverse emotional conditions when substance access is impeded, as defined in the 2016 study Koob GF. and Volkow ND., titled "Neurobiology of addiction: a neurocircuitry analysis," published in The Lancet Psychiatry.

People dependent on morphine may encounter difficulty establishing boundaries on their substance intake, persist in morphine usage despite suffering detrimental impacts on their bodily and psychological wellbeing, and face obstacles in ceasing or decreasing its consumption despite genuine attempts.

Loss of control represents a distinctive characteristic of addiction, demonstrating the disruptive influence of morphine on the individual's capacity to form rational and beneficial decisions regarding substance use. Tackling this symptom is vital in addiction treatment to assist individuals in reclaiming authority over their actions and shifting attention away from the fixation on securing morphine.

3. Obsessive focus on obtaining the drug

Fixation on acquiring morphine involves the compulsive and unrelenting concentration on obtaining morphine, controlling one's thoughts and behaviors. Those affected by this symptom undertake persistent efforts to secure morphine, frequently sacrificing personal, social, or professional commitments.

In the SAMHSA's 2016 report "Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health," chapter 2, titled "The neurobiology of substance use, misuse, and addiction," the preoccupation or anticipation stage in the addiction cycle is defined as the phase where an individual, especially those with severe substance use disorders, including morphine addiction, become intensely focused on using substances and experience abstinence quite soon, sometimes in just a few hours.

This preoccupation stems from the pressing need to fulfill the addiction, commonly resulting in compromised judgment and an increased likelihood of problematic substance-seeking conduct. Managing this symptom diverts the individual's attention toward more beneficial options and lessens the difficulties linked with enduring unpleasant withdrawal manifestations.

4. Onset of withdrawal symptoms

Experiencing withdrawal symptoms refers to the collection of physical and psychological manifestations that emerge when a person dependent on morphine suddenly decreases or stops its consumption.

As per the SAMHSA's 2016 report "Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health," chapter 2, titled "The neurobiology of substance use, misuse, and addiction," when the substance is unavailable, individuals go through withdrawal, encountering negative emotions such as stress, anxiety, or depression, along with physical discomfort.

The indicators of withdrawal symptoms, including drug cravings, anxiety and irritability, sweating, runny nose and sneezing, insomnia, and headaches, act as an evident indication of the formation of physical reliance on morphine.

Comprehending bodily discomforts and emotional fluctuations experienced by individuals struggling with morphine dependency is vital to successfully managing the initial phases of recovery.

5. Emotional instability

Emotional fluctuations denote sudden and pronounced shifts in an individual's mood state, involving alternating periods of elevated and depressed emotions. As a symptom of morphine dependency, emotional fluctuations are commonly observed due to the neurochemical changes caused by morphine on the central nervous system.

Janni Leung et al., in the 2022 study, titled "Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies," published in the Pain Medicine, indicated that individuals using prescription opioids like morphine faced an increased risk of experiencing mood-related issues and anxiety-related issues compared to those not using prescription opioids.

The study underscored the importance of taking mental health into account when prescribing opioids, as certain patients are susceptible to adverse mental health consequences.

Persons dependent on morphine encounter euphoria and elation when affected by the substance, subsequently experiencing periods of irritability, anxiety, or depression during withdrawal or when the substance is unavailable.

These unpredictable mood variations contribute to the cyclical nature of addiction, impacting an individual's conduct and daily existence, which results in diminished enthusiasm for everyday pursuits that were previously pleasurable.

6. Decline in interest in normal routines

Diminished enthusiasm for activities indicates a reduced or total absence of interest, participation, or pleasure in pursuits and pastimes that a person previously considered enjoyable or gratifying. Morphine dependents frequently experience diminished enthusiasm for activities due to certain interrelated biological and psychological elements.

According to the findings of the 2021 study by Rosoff DB. et al., titled "Prescription Opioid Use and Risk for Major Depressive Disorder and Anxiety and Stress-Related Disorders: A Multivariable Mendelian Randomization Analysis," published in JAMA Psychiatry, morphine, and other opioids act on the brain's reward system, primarily through the activation of mu-opioid receptors (MORs) and kappa-opioid receptors (KORs).

These receptors play a crucial role in the perception of pleasure and reward. The brain's reward system becomes altered and less responsive to natural rewards with prolonged use. This means that activities that used to bring pleasure no longer have the same effect, leading to a general loss of interest.

7. Seeking prescriptions from multiple providers

Prescription hopping involves the practice of consulting multiple healthcare providers to secure prescriptions for opioids or other regulated substances, frequently to gain a larger quantity of the drug than what a single provider prescribes.

Individuals dependent on morphine deplete various medical resources, pursuing prescriptions from different physicians or clinics, either concurrently or consecutively. This conduct is motivated by the wish to obtain a greater supply of morphine to satisfy increasing tolerance thresholds or to sustain the pleasurable effects of the drug.

A 2023 study conducted in France by Soeiro T. et al., named "Systematic assessment of non-medical use of prescription drugs using doctor-shopping indicators: A nation-wide, repeated cross-sectional study," found that opioids, such as morphine, had the highest proportions of doctor-shopped medications during the study period, indicating a significant issue with non-medical use of these substances.

Prescription hopping is not merely suggestive of a substance use disorder but also presents considerable dangers for potential overdose and negative health outcomes. Tackling this symptom will assist in preventing compromised physical and mental functioning and foster a thorough recovery strategy.

8. Reduced cognitive and physical abilities

Compromised physical and mental functioning refers to a reduction in a person's capability to perform optimally in both bodily and cognitive domains.

In a 2016 study led by Kim J. et al., titled "Brain Reward Circuits in Morphine Addiction," and published in the Molecules and Cells journal, the experts outlined that morphine addiction leads to impaired mental performance due to its effects on various brain circuits and biochemical pathways.

One of the key factors in this impairment is the alteration of brain reward circuits. Morphine impacts the ventral tegmental area (VTA), which projects dopaminergic transmission to several brain regions involved in reward processing and mood regulation, such as the nucleus accumbens, medial prefrontal cortex, and amygdala.

These changes lead to altered cognitive and emotional processing, impairing mental performance. According to the American Psychiatric Association's 2022 issue on "Opioid Use Disorder," opioids like morphine induce physical dependence in just four to eight weeks. During this period, the body becomes accustomed to opioids, making it challenging to function without them.

9. Persistent grogginess or disorientation

This symptom refers to ongoing mental cloudiness, confusion, or difficulty staying alert. People with morphine addiction often feel dazed, struggle to concentrate, or lose awareness of their surroundings.

Morphine causes this by depressing the central nervous system and interfering with brain regions responsible for focus and alertness. Over time, repeated use disrupts normal neurotransmitter activity and impairs cognitive function.

Research by Listos et al. (2019) shows that chronic morphine use alters brain structures like the prefrontal cortex and hippocampus, leading to slowed thinking and disorientation. Suliman and Bakar (2022) further link long-term morphine exposure to neurochemical changes that reduce mental clarity.

What are the signs of Morphine addiction?

Morphine dependency manifests through physical, behavioral, and psychological signs. The common signs of morphine dependency are listed below.

• Unsuccessful attempts to quit: Individuals experiencing morphine dependency often struggle to break free from the substance despite repeated efforts, reflecting a persistent and challenging cycle of dependency.
• Neglecting responsibilities: Morphine dependency leads to a decline in fulfilling obligations, as individuals prioritize drug use over important duties, jeopardizing relationships, work, or other responsibilities.
• Social withdrawal: A common behavioral sign of morphine dependency involves the gradual withdrawal from social activities and relationships, as individuals may isolate themselves to conceal their dependency or due to the impact of the drug on their interpersonal skills.
• Risky behaviors: Morphine dependency prompts individuals to engage in risky activities, disregarding potential consequences, as the drug's influence impairs judgment and decision-making.
• Deceitful behavior: Dependent individuals resort to dishonesty to conceal their substance abuse, creating a pattern of secrecy and mistrust in their interactions with others.
• Presence of withdrawal symptoms: The manifestations of withdrawal symptoms, including drug cravings, anxiety and irritability, sweating, runny nose and sneezing, insomnia, and headaches serve as a clear signal of the development of physical dependence on morphine. Withdrawal symptoms emerge when individuals abruptly reduce or discontinue morphine use.
• Limp body: The limp body is characterized by muscle relaxation and reduced muscle tone. This manifestation occurs as a result of the central nervous system depressant effects of morphine, leading to a state of physical lethargy and relaxation.
• Falling asleep or loss of consciousness: Falling asleep or loss of consciousness is when individuals under the influence of morphine experience a heightened propensity for excessive drowsiness or periods of unconsciousness.
• Pale, blue, or cold skin: Pale, blue, or cold skin indicates poor blood circulation, respiratory depression, or other physiological effects associated with opioid use that require prompt medical attention. These skin changes are potential indicators of severe complications related to morphine misuse
• Pinpoint pupils: Small pupils are a physiological sign associated with morphine use, as the drug affects the autonomic nervous system, leading to changes in the size of the pupils.

What are the long-term effects of Morphine addiction?

Morphine addiction leads to lasting physical, cognitive, and hormonal complications. The long-term effects outlined below reflect the drug’s widespread impact on the body and brain:

• Tolerance and dependence: Over time, individuals require higher doses of morphine to achieve the same level of relief or euphoria. A 2020 study by Zeng XS et al. in Frontiers in Pharmacology notes that this escalating tolerance increases the risk of relapse and deepens physical dependence.
  
• Chronic constipation: Opioid-induced constipation (OIC) affects 15% to 81% of long-term users, according to a 2019 review in The Korean Journal of Pain. This condition can significantly impair quality of life and often leads patients to abandon therapy.
  
• Respiratory depression: Prolonged morphine use suppresses breathing by acting on brainstem receptors. This effect becomes dangerous with high doses or co-use of other depressants, as noted by Murphy PB et al. in the 2023 StatPearls review on morphine.
  
• Cognitive impairment: Chronic use of morphine alters neural pathways involved in memory, attention, and learning. A 2023 study in Psychiatry Research highlights that cognitive decline can both contribute to and result from opioid addiction.
  
• Hormonal issues: Long-term morphine use disrupts the endocrine system by lowering gonadotropin-releasing hormone (GnRH), leading to reduced testosterone, infertility, muscle loss, and depression. This was reported in a 2012 study by Seyfried and Hester.
  
• Overdose risk: Extended non-medical use of morphine significantly increases the risk of overdose. The WHO (2023) confirms that morphine can cause fatal respiratory failure, especially when taken without medical oversight.
  
• Intense euphoria and pain relief: While initially therapeutic, the euphoric effects of morphine contribute to its addictive potential. These effects are tied to the overstimulation of opioid receptors, reinforcing compulsive use and accelerating dependence, as supported by research aggregated on Consensus.
  
• Brain damage: Chronic morphine use has been linked to neurotoxicity and structural brain changes. These effects impair brain function over time and may lead to long-term neurological deficits, especially when use begins early or continues for years.
  
• Pregnancy risks: Morphine use during pregnancy is dangerous. It can lead to neonatal opioid withdrawal syndrome (NOWS), impaired fetal development, and low birth weight. Studies show that opioids cross the placental barrier, affecting the fetus's central nervous system development.

Together, these long-term effects underscore the need for early intervention, continuous monitoring, and a comprehensive treatment approach for individuals dependent on morphine.

What are the short-term side effects of Morphine addiction? 

Morphine addiction produces a range of immediate physiological and psychological effects. These short-term side effects result from how morphine interacts with the central nervous system and opioid receptors throughout the body:

• Intense euphoria and pain relief: Morphine rapidly induces a state of deep relaxation, emotional numbness, and pleasure by activating mu-opioid receptors. This intense euphoria reinforces repeated use, which is a key factor in the early development of addiction.
  
• Drowsiness and mental fog: Morphine depresses brain activity, causing sedation, slowed thinking, and impaired decision-making. Users may appear lethargic or disoriented, with reduced ability to focus.
  
• Constipation and nausea: Even in the short term, morphine slows gastrointestinal movement, often resulting in nausea, vomiting, and early signs of opioid-induced constipation.
  
• Respiratory suppression: Morphine slows breathing by acting on brainstem receptors, which can lead to shallow or slowed respiration, especially dangerous at higher doses or when combined with other depressants.
  
• Pupil constriction: Pinpoint pupils are a common physical sign of opioid use and may appear within minutes of taking morphine.
  
• Lowered blood pressure and dizziness: Morphine can cause orthostatic hypotension (a drop in blood pressure when standing), resulting in dizziness or fainting.
  
• Impaired motor coordination: Muscle weakness and poor balance may occur due to morphine’s effect on the nervous system.

How Much Morphine Can Be Deadly?

The lethal quantity of morphine for adults is generally considered to be about 250 mg, and it can be identified in the bloodstream at concentrations as low as 0.5 μg/mL, according to the 2021 Forensic Science International: Reports article, "Forensic aspects about fatal morphine intoxication of an unusual body packer: Case report and literature review."

However, the fatal dose of morphine differs from person to person and is affected by factors such as individual tolerance, general health, and the presence of other drugs or substances.

As noted in the Health Care Compliance Association’s (HCCA) 2021 March conference handout, “What Is the Maximum Permissible Dose of Morphine-or Fentanyl?” by Bradford D. Winters, Ph.D., M.D. and David N. Hoffman, J.D., the primary danger of opioid use stems from their ability to suppress respiratory function, which can have deadly outcomes.

Murphy PB. et al., in the study “Morphine,” last updated in May 2023 in StatPearls, highlighted that misusing morphine can result in death. In overdose situations, the most severe complication is profound respiratory depression.

What are the causes of Morphine addiction?

The typical causes of morphine dependency are detailed below.

• Medical prescriptions: Morphine is frequently prescribed for pain management, and individuals may develop dependence and addiction during the course of medical use, particularly with prolonged treatment.
• Genetic factors: A genetic predisposition to addiction can make some people more likely to develop dependence on opioids such as morphine.
• Mental health issues: Co-existing mental health conditions like depression, anxiety, or trauma contribute to substance abuse, as individuals may use opioids to manage emotional discomfort.
• Social and environmental factors: Availability of opioids, social circles, and environmental influences play a part in the onset of addiction. Peer pressure and easy access to the drug further contribute to morphine dependency.
• Previous substance abuse: Those with a background of substance use, whether involving opioids or other drugs, face a higher risk of developing addiction to morphine.
• Neurobiological factors: Opioids, including morphine, impact the brain's reward pathways, and some individuals are particularly responsive to these rewarding effects, heightening their risk for addiction.

How long does it take to get addicted to morphine?

Addiction to morphine can begin in as little as one to three weeks of regular use, especially when taken daily or in higher-than-prescribed doses. According to the American Psychiatric Association and addiction research cited in StatPearls (2023), physical dependence can develop within 7 to 14 days of continuous opioid use, with psychological cravings often emerging shortly after.

The risk increases significantly if morphine is used multiple times per day, without medical supervision, or in higher doses than prescribed. Even short-term use, such as one week, can lead to early signs of dependence in individuals with certain risk factors (e.g., history of substance misuse, mental health conditions, or genetic vulnerability).

Therefore, while not everyone will become addicted after a few doses, consistent use over a two- to three-week period, especially for non-medical purposes, can lead to tolerance, withdrawal symptoms, and eventually addiction.

Can you get addicted to morphine in the hospital?

Yes, it is possible to develop a dependence on morphine even during hospital treatment, though addiction in a strictly monitored medical setting is less common.

Morphine is routinely used in hospitals for managing moderate to severe pain, especially after surgery, injury, or in cases of cancer-related pain. When administered under professional supervision for short durations and at medically appropriate doses, the risk of addiction is generally low. However, if morphine is used for longer than a few days or if a patient requires multiple doses over consecutive days, the body can begin to develop tolerance and physical dependence.

Certain patients are more vulnerable to becoming addicted, even in a clinical setting. These include individuals with:

• A personal or family history of substance use disorder
• Underlying mental health conditions like anxiety or depression
• High-dose or extended morphine treatment

While hospitals aim to minimize risks through strict dosing and monitoring protocols, studies show that dependence can begin within 7 to 14 days of regular opioid use. If morphine use continues after discharge without careful tapering or follow-up, the transition from therapeutic use to misuse becomes more likely.

In short, addiction can begin in the hospital, especially if morphine is used beyond the acute pain phase or not tapered properly afterward. This risk highlights the importance of ongoing pain management plans and close medical oversight during and after opioid treatment.

What are the risk factors for Morphine addiction?

The risk factors associated with morphine dependency are varied and complex. Extended use or consumption of high doses of morphine is a major risk factor, as it fosters the development of tolerance, necessitating increased dosages over time and raising the likelihood of dependence.

Simultaneous use of medications that influence the central nervous system intensifies morphine’s effects, increasing the potential for negative outcomes, including addiction.

Individuals with a background of previous or current substance misuse, as well as those with either a personal or family history of addiction, face a higher risk due to inherent susceptibilities.

Underlying health issues or disorders, such as chronic pain or psychiatric conditions, also elevate the risk of morphine dependency, as individuals may turn to opioids to manage symptoms or self-medicate.

Age serves as an additional risk factor, with younger individuals being more inclined toward risk-taking behaviors and their developing brains being more vulnerable to the pleasurable effects of morphine, thus increasing addiction risk.

The influence of the social or family environment is significant, as exposure to substance use or the absence of strong support systems can contribute to both the onset and persistence of morphine use.

Additionally, ready availability of morphine-either through medical prescriptions or illegal sources-further raises the risk of misuse and dependency.

What Makes Morphine So Addictive?

Morphine use is habit-forming because, over time, the brain adjusts to its presence, resulting in tolerance-meaning larger amounts are required to achieve the same results. Moreover, ongoing stimulation of the brain's reward pathways leads to neurobiological alterations that foster dependence and, ultimately, addiction. These combined pharmacological and neurological influences make morphine use highly likely to lead to addictive patterns.

Even when taken as directed for a limited period, morphine can cause dependence, according to the Australian healthdirect article, "Taking opioid medicines safely," last updated in May 2023. Tolerance can also set in, making higher doses necessary for the same benefit, which further increases the risks of negative side effects and addiction.

How addictive is the use of Morphine?

Morphine is highly addictive because of its powerful impact on the brain's reward mechanisms. The likelihood of developing morphine dependency differs according to personal characteristics and usage patterns.

As noted in Jahangir Moini et al.'s 2021 book, titled "Global Emergency of Mental Disorders," chapter "The opioid epidemic," morphine is classified as a Schedule II drug in the United States. It is typically listed in the most tightly regulated drug schedules in other countries.

Is morphine more addictive than oxycodone?

There is no clear consensus; research presents mixed findings, and both opioids carry a high risk of addiction.

Some studies suggest that morphine may be slightly more addictive due to its higher reinforcement potential and its ranking on addiction scales. A well-cited study published in The Lancet ranked morphine among the most addictive substances, scoring 3.0 out of 3.0 across physical dependence, psychological dependence, and pleasure. Its ability to induce strong euphoria and stimulate opioid receptors leads to significant cellular changes, reinforcing continued use.

On the other hand, oxycodone is often reported as equally or even more addictive in real-world settings. It has a higher oral bioavailability and is commonly prescribed in fast-acting formulations, which may increase the risk of misuse. Some patients report more intense euphoria with oxycodone, especially in non-medical use, making it a frequent target for abuse.

What are the available treatments for Morphine addiction?

The available treatments for morphine addiction are listed below.

• Medically supervised detox
• Cognitive-behavioral interventions
• Medication-based therapies
• Peer and therapeutic support groups
• Residential rehabilitation programs
• Outpatient recovery programs
• Integrated care for co-occurring disorders
• Therapy involving family participation

1. Medically supervised detox

Detoxification, or detox, is a process focused on handling and alleviating the withdrawal symptoms that arise when someone ceases using a substance like morphine. The primary objective of detox is to manage the acute physical effects of withdrawal-such as nausea, vomiting, muscle pain, and anxiety-in a safe manner, helping the individual achieve physical stability.

For those affected by opioid use disorder (OUD), including morphine dependency, detoxification is the initial stage of the overall treatment approach. However, detox by itself is not sufficient, as many individuals with OUD are likely to relapse without further treatment, as noted in the Harvard Health Publishing 2019 issue, "Treating opiate addiction, Part I: Detoxification and maintenance."

Typically, detox is followed by a more extensive addiction treatment plan, which may include behavioral therapies, counseling, and participation in support groups.

2. Cognitive-behavioral interventions

Cognitive behavioral therapy is a psychological method designed to recognize and alter negative thinking and behavioral patterns.

CBT is specifically adapted for individuals managing chronic pain and opioid use disorder (OUD). This therapeutic approach seeks to strengthen coping strategies, addressing common clinical issues faced by patients experiencing these conditions.

The main objective of CBT is to disrupt the dysfunctional link between pain and OUD, where individuals, in an effort to alleviate pain or emotional discomfort, turn to inappropriate opioid or substance use. This behavior leads to unfavorable consequences that further complicate pain management, as described by Marina G. Gazzola et al., in the 2022 book "Treatments, Mechanisms, and Adverse Reactions of Anesthetics and Analgesics," "Chapter 22 – Cognitive behavioral therapy for chronic pain and opioid use disorder."

3. Medication-based therapies

Medication-assisted treatment (MAT) is a scientifically supported method for addressing addiction that integrates medication use with counseling and behavioral therapies.

According to a 2021 study, "A Personalized, Interactive, Cognitive Behavioral Therapy–Based Digital Therapeutic (MODIA) for Adjunctive Treatment of Opioid Use Disorder: Development Study," featured in JMIR Mental Health publications, MAT represents the leading treatment strategy for opioid addiction and delivers a comprehensive approach.

The U.S. Food & Drug Administration’s May 2023 issue on “Information about Medication-Assisted Treatment (MAT)” notes that there are currently three FDA-approved medications for treating opioid dependence: buprenorphine, methadone, and naltrexone.

Research demonstrates that when combined with counseling and psychosocial support, these medications are both safe and effective, helping to reduce cravings, improve treatment adherence, and promote long-term recovery.

4. Peer and therapeutic support groups

Group therapy and support groups are therapeutic methods that bring together individuals with shared experiences, such as morphine dependency, to exchange challenges, insights, and coping mechanisms in a welcoming environment.

The BioMed Central 2021 issue, "A review of research-supported group treatments for drug use disorders," notes that individuals participating in group therapy for substance use disorders generally make greater strides compared to those receiving standard treatment without group participation.

The StatPearls article, "Opioid Use Disorder," updated in July 2023, highlights that self-help initiatives like Alcoholics Anonymous, Narcotics Anonymous, and 12-step programs encourage behavioral changes through mutual support and peer encouragement. These approaches offer education, motivation, and aim to reshape participants’ views on the impact of opioid use. Moreover, group therapy approaches are recognized for their cost-effectiveness.

5. Residential rehabilitation programs

Inpatient or residential treatment requires individuals to live in a dedicated facility for an extended duration to receive comprehensive care for morphine dependency.

According to the MedLinePlus article “Opioid Use Disorder (OUD) Treatment,” updated in July 2023, inpatient programs combine accommodation and treatment, creating a supportive setting where individuals live alongside others in recovery, offering mutual support throughout the process.

Within these programs, skilled medical staff provide around-the-clock care at the facility. Typically, a physician, or sometimes a physician’s assistant or nurse practitioner, conducts daily evaluations with each patient in the inpatient unit, seven days a week.

6. Outpatient recovery programs

Outpatient treatment for morphine dependency involves receiving therapeutic interventions and support while continuing to live at home and manage everyday responsibilities. This approach offers flexibility, enabling individuals to attend scheduled therapy sessions, counseling, and support groups during the day, then return to their homes in the evenings.

In the 2014 study “Substance abuse intensive outpatient programs: assessing the evidence,” published in Psychiatric Services, McCarty D. et al., described outpatient programs as alternatives to inpatient and residential care, focusing on building psychosocial support networks and fostering effective strategies for relapse prevention and coping.

Intensive outpatient programs (IOPs) for substance misuse, including morphine use, offer a structured recovery framework for those who do not require medical detoxification or round-the-clock monitoring. IOPs deliver comprehensive treatment and support while preserving participants' autonomy and allowing them to maintain their daily routines.

7. Integrated care for co-occurring disorders

Dual diagnosis treatment is an integrated approach that simultaneously addresses substance use issues, such as morphine dependency, alongside co-occurring mental health disorders. This method is especially beneficial for morphine dependency, recognizing the intricate connection between substance misuse and mental health challenges. Treating both conditions together increases the likelihood of sustained recovery.

A 2014 study by McGovern MP. et al., “Dual diagnosis capability in mental health and addiction treatment services: an assessment of programs across multiple state systems,” utilized the dual diagnosis capability in addiction treatment (DDCAT) and dual diagnosis capability in mental health treatment (DDCMHT) indexes to evaluate program effectiveness, examining 256 programs across the United States.

The study found that 18% of addiction treatment centers and 9% of mental health facilities were equipped for dual diagnosis care, meaning individuals in these programs have about a 1 in 10 to 2 in 10 chance of receiving comprehensive treatment for both addiction and mental health conditions.

8. Therapy involving family participation

Family therapy incorporates relatives into the recovery process for those dealing with morphine dependency. This approach acknowledges the role that family interactions play in addiction and seeks to resolve interpersonal issues, enhance communication, and reinforce the family’s support network.

A 2017 study, "Multi-Family Therapy with a Reflecting Team: A Preliminary Study on Efficacy among Opiate Addicts in Methadone Maintenance Treatment," published in the Journal of Marital and Family Therapy, highlighted the positive effects of multi-family therapy (MFT) in lessening addiction severity and improving both psychological health and family relationships among opiate users in methadone maintenance programs.

The findings indicated that family-oriented therapies not only decrease addiction severity but also contribute to better employment outcomes, increased social support, and improvements in psychiatric well-being for patients.

What are the symptoms of Morphine withdrawal?

Morphine withdrawal symptoms differ in their severity and how long they last, typically appearing when someone who has been using morphine regularly suddenly stops or greatly reduces their intake. Common symptoms of morphine withdrawal are listed below.

• Drug cravings: Powerful urges or intense desires to use morphine, representing a mix of psychological and physiological urges. These cravings can be overwhelming and pose a significant challenge in resisting relapse.
• Anxiety and irritability: Heightened anxiety and irritability are common, stemming from an overactive nervous system response. This results in increased arousal and sensitivity, contributing to persistent nervousness.
• Sweating: Noticeable sweating often intensifies the discomfort experienced during withdrawal. Excessive sweating reflects the body’s efforts to readjust to the lack of morphine after its abrupt interruption of the central nervous system.
• Runny nose and sneezing: Nasal congestion, runny nose, and frequent sneezing may occur, mimicking cold or flu-like symptoms.
• Insomnia: Difficulty falling or staying asleep is prevalent, as the sudden absence of morphine disrupts neural pathways involved in regulating sleep, leading to disturbances in the natural sleep-wake cycle.
• Dilated pupils: Enlarged pupils are a visible sign of the significant physiological changes occurring as the body readjusts and attempts to restore natural regulatory functions.
• Headaches: Frequently reported and caused by a combination of physiological and neurological changes, headaches result from disrupted neurotransmitter and receptor balances and altered blood flow patterns.
• Hot and cold flushes, goosebumps: The sudden stop in morphine throws off the body’s temperature regulation, resulting in cycles of warmth and chills, with goosebumps indicating difficulty maintaining a stable body temperature.
• Muscle aches and pains: The removal of morphine’s analgesic effects exposes individuals to an increased awareness of discomfort, leading to widespread soreness in various muscle groups.
• Nausea, vomiting, and diarrhea: Gastrointestinal upset is common, including nausea and vomiting, which complicate the withdrawal process and can lead to dehydration and nutritional deficiencies. Increased, often loose, bowel movements are also observed.
• Increased heart rate: The body’s heightened sympathetic response leads to tachycardia, or a rapid heartbeat, as it adjusts to the absence of morphine.

How long does morphine withdrawal last?

Morphine withdrawal typically lasts 7 to 10 days, though the exact duration can vary depending on the individual's level of dependence, dosage history, and overall health. Symptoms often begin within 6 to 12 hours after the last dose, peaking around day 2 or 3. During this acute phase, individuals may experience intense cravings, anxiety, sweating, nausea, and muscle aches. By day 5 to 7, most physical symptoms begin to ease. However, some people, especially those with long-term or high-dose use, may experience lingering psychological symptoms such as irritability, sleep disturbances, or mood swings for several weeks. This extended phase, known as post-acute withdrawal, may require ongoing support and treatment.

What are some famous celebrities addicted to morphine? 

Morphine addiction refers to the compulsive and uncontrollable use of morphine, an opioid pain reliever, despite harmful consequences. Like many prescription opioids, morphine can lead to physical dependence, psychological cravings, and long-term addiction. Several well-known public figures have struggled with morphine or similar opioid addictions, often as a result of injury, chronic pain, or emotional distress.

Celebrities who have reportedly struggled with morphine or opioid addiction include:

• Judy Garland – The legendary actress of The Wizard of Oz was known to have struggled with multiple substances, including morphine, which was widely used in Hollywood at the time for weight control and emotional regulation.
• Elvis Presley – The music icon was prescribed a variety of opioid medications for chronic pain, including morphine, contributing to his dependence and declining health in his final years.
• Marilyn Monroe – Though better known for barbiturate use, Monroe’s toxicology reports and public accounts also link her to morphine use during periods of emotional instability and physical exhaustion.
• John Belushi – The Saturday Night Live star reportedly abused multiple substances, including morphine, which contributed to his fatal overdose in 1982.
• Anna Nicole Smith – The model and television personality had a well-documented history of prescription drug addiction, including opioids such as morphine, which were found in her system after her death.

Please note that while some of these associations are based on toxicology reports or biographies, others are drawn from public records and media coverage and may not reflect official medical diagnoses.