Morphine: What You Need To Know
Morphine is an opioid found naturally in the opium poppy plant, making it an opiate. It's a very euphoric, pain relieving, and sedating drug that's been used in recreational and medicinal settings for thousands of years. Until relatively recently, it was used as part of preparations of opium, but it is now isolated for use on its own.
It's also an endogenous drug, meaning it can be found naturally in the human body. Among the positive of morphine are euphoria, pain relief, mood elevation, anxiety reduction, internal hallucinations, and a general feeling of happiness and contentedness. The negative effects include respiratory depression, constipation, nausea, difficulty urinating, itchiness, and minimally impaired physical and cognitive performance, at least at medical doses. Morphine's euphoria is often greater than what you'd see with other opioids, though not always. In this regard it is similar, if not identical, to heroin.
The euphoria is described as a strong feeling of comfort, warmth, and love. One of the issues with morphine which can be considered a negative effect is that dependence easy develops and withdrawal can be incredibly unpleasant. If you use it orally, morphine lasts for 4 to 6 hours and begins working in 10 to 30 minutes. Extended release options also exist which can increase the onset to 90 minutes and the duration to 10 hours. Rectally, the drug lasts for 3 to 4 hours and has an onset of 10 to 30 minutes. With intravenous use, the duration is only 1 to 2 hours and the onset is just a few seconds. I won't talk much about intramuscular use, but through that route, the onset is a little slower which results in less of a rush. Morphine operates at mu, delta, and kappa opioid receptors in the central nervous system and in other parts of the body.
Its activity at mu-opioid receptors in the gastrointestinal tract, for example, is connected to its ability to cause constipation. The mu-opioid action is connected to morphine's euphoria, sedation, respiratory depression, and pain relief. The kappa-opioid receptors are connected to pain relief, pupil constriction, and possibly some of the hallucinations that occur with the drug.
Lastly, the delta-opioid receptors probably play some role in pain relief. At some point in its action, sigma receptors may be involved since sigma agonists and antagonists augment what morphine does. There's also an interesting subtype of the mu-opioid receptor, the mu-3 receptor, which is a binding site for morphine. The discovery of this receptor helped confirm morphine is an endogenous drug because other endogenous opioids don't bind to it.
As an interesting chemistry side-note, scientists are now trying to get a full sugar to morphine synthesis to occur in yeast. Morphine has been used for thousands of years in the form of opium. Friedrich Serturner, an apothecary assistant, isolated morphine as a core active chemical in opium in either 1804 or 1805. He initially called it "morphium" in reference to Morpheus, the Greek god of dreams. That reference was made because he knew he had found opium's sleep-inducing chemical. In 1817, Serturner began promoting it for pain relief and the treatment of opium and alcohol addiction.
He found it was useful for pain relief after testing it on dogs, himself, and local individuals. Merck, which is still one of the largest pharmaceutical companies, began commercially producing morphine in 1827. The drug was widely used in multiple wars due to it being an effective pain reliever and sedative.
In the US, the Civil War saw widespread use and morphine went on to appear in World War 2 and other conflicts. The commercial availability of hypodermic syringes in the 1860s began to transform how morphine was used. It was a commonly used drug in medical and non-medical settings through the 1800s and early 1900s, but laws started to restrict access. The Pure Food and Drug Act of 1906 required morphine content be labeled on products. And in 1914, the Harrison Narcotics Tax Act criminalized the non-medical possession of morphine. Morphine certainly didn't disappear due to the laws, and to this day, morphine is used in medical and recreational settings. During the 1900s, multiple total synthesis methods for morphine were published. Even now, however, no total synthesis has proven to be a better option than obtaining morphine from the opium poppy.
Since being isolated in Papaver Somniferum, morphine has been found in other plants and animals, including humans. Morphine is currently a common medical substance for many conditions and it's been used in some countries as a replacement for other opioids. Recreational use does take place, but heroin and other opioids have largely taken over that market. When used orally, a normal dose of morphine is 15 to 25 mg and a strong dose is over 30 mg. I recognize this is much lower than a lot of people use, but for a number of reasons, a normal dose is what should be used. There's a lack of good dosing information for rectal and IV administration. As such, I'm not confident with providing those doses.
In the United States, morphine is a Schedule 2 drug. It's illegal in most countries, including Australia, Canada, France, and the UK. Overall, morphine isn't a terribly dangerous substance when used in a safe way acutely or in the long-term. However, digging into the drug a little more, there are concerns that exist.
The biggest immediate concern is an overdose. An overdose can occur with around 2 to 3 times the recreational dose, coming out to 200 mg orally. If you are sensitive, that dose may be even lower.
Due to its bad effective to dangerous dose ratio, morphine is easily capable of being acutely dangerous when you use too much. Respiratory depression quickly becomes an issue and when enough morphine is used, it's deadly. Also, even without an otherwise fatal dose, morphine sometimes causes vomiting.
This is a problem because if you're too sedated, the vomit may enter your respiratory tract and cause death. Naloxone is able reverse an overdose, but if no one is around to help you, an overdose can easily be fatal. Assuming it's used safely, there are still some concerns with morphine. Dependence does build quickly if you use the drug often and like with other opioids, withdrawing from morphine can be very uncomfortable.
It's not going to be deadly in an otherwise healthy person, but the withdrawal isn't something you want to go through. Regular use also has a tendency to cause constipation. And it may also throw off hormones in both men and women. Hypogonadism occurs in many regular users and the levels of multiple important hormones can be greatly reduced. This is a temporary effect, but if allowed to continue for too long, it could lead to a number of issues. One of which is an increased risk of bone fracture. Lastly, it's dangerous to combine morphine with other CNS depressants.
That means alcohol, ketamine, benzodiazepines, and others don't make for a good combination. If you have any questions about morphine, feel free to leave them in the comments section. You can also leave them in the Reddit thread for this video, which will be linked in the description.
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