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Beach House Rehab Center » Blog » Morphine Detox Guide
The drug behind the first opiate-addiction crisis in mainstream America, morphine is still prescribed today. And it’s still a frequent cause of addiction disorders.
In 1805, German scientist Friedrich Sertürner became the first to extract morphine from opium, and unwittingly set in motion a chain of events leading to the first opiate-painkiller-addiction epidemic in the United States. Morphine, with ten times the intoxicating power of opium, was widely used by military doctors during the Civil War, and also by civilian doctors as a painkiller and antidepressant. By 1895, it was the primary offender in an addiction crisis affecting as many as one in 200 Americans.
While only about half as strong as heroin, morphine is still causing addictions today. It is also still prescribed legally as a painkiller, usually to patients who have developed tolerance to other opiate medications. (Currently, morphine is classified as a Schedule II drug in the U.S., which means the government officially recognizes its medical value but also its dangerously high addiction potential.)
Morphine withdrawal, like all opiate withdrawal, produces severe flulike symptoms:
While withdrawal is rarely life-threatening in itself, it does occasionally happen that someone turns suicidal, becomes seriously dehydrated from diarrhea and vomiting, or even experiences a seizure or heart attack.
Physical withdrawal as a whole typically lasts about a week and begins within six hours of the last morphine dose. Initially, physical symptoms will be mild: runny nose, teary eyes, minor aches and pains, longings for a fresh dose of morphine.
By the end of the first 24 hours, physical pains and cravings become intense. Diarrhea and vomiting begin in earnest. Blood pressure rises. Other symptoms reach their peak. This stage lasts two or three days (which to many patients feels like forever).
Around the fourth day, a patient begins to feel better. By the end of the first week, most symptoms have disappeared, though morphine cravings may return periodically for weeks.
This is, of course, merely a typical withdrawal timeline: the detox procedure may take several days more or fewer for various individuals. Factors that affect intensity and duration of withdrawal include:
Detox from morphine is best managed under medical supervision, which is readily available: in recent years, the rise in general opiate addiction has prompted a corresponding rise in professional treatment options. By the end of 2016, the Substance Abuse and Mental Health Services Administration recognized nearly 1,500 opiate treatment programs in the United States.
Since a newly detoxed patient is still inclined to reach for more morphine under stress, up to three months of follow-up care and therapy (including coaching for drug-free pain management) is recommended to prepare the patient for a morphine-free future. Inpatient care, which involves residential hospitalization, is frequently recommended because:
Anyone without a solid support network on the outside almost certainly needs inpatient care. So does anyone with a dual diagnosis (a mental illness apart from the addiction).
For all its advantages, inpatient care isn’t for everyone. The pros of going home right after detox may outweigh the cons if someone:
Even then, the patient needs professional therapy and accountability for the first few months after physical detox. The solution is outpatient treatment, which involves reporting to aftercare facilities several times a week. Most outpatient programs use one of the following models:
Most people in outpatient situations, especially if living beyond walking distance of the detox center, are more vulnerable to relapse than those in structured and supervised environments. It’s important to have a detailed relapse-prevention plan, family support and strong accountability.
Looking at everything involved in both inpatient and outpatient treatment, many people think, “Wouldn’t it be easier to quit cold at home? It’ll hurt, but it won’t kill me, right?”
Well, aside from the rare but real physical risks (noted under Morphine Withdrawal Symptoms, above), and the increased risk of overdose if someone gives up the fight and puts a “normal” dose of morphine into a partially detoxed body, there’s much more to addiction recovery than just getting through physical withdrawal. Without counseling to pinpoint the reasons behind the addiction, and a support plan for dealing with a recurrence of cravings, a person has limited motivation or accountability to avoid going back to morphine as soon as life gets stressful again.
Even in a clinical setting, there are varying opinions on the safest forms of detox. Many clinics opt for the cold turkey approach of cutting off all drugs and simply keeping the patient comfortable, rather than risk possible complications from substitute opiates. Other programs use “tapered” or medication-assisted treatment (MAT), administering replacement opiates such as Suboxone to satisfy cravings without the risks of taking actual morphine.
While MAT makes withdrawal less agonizing, there are cases of patients staying on the substitute drug indefinitely and becoming as desperately dependent on it as on the original morphine. Therefore, every MAT program should include a plan to taper off the new medication through gradually reduced doses, until a patient is weaned from all cravings and completely opioid-free.
Once a morphine detox client is clear on the preferred medical approach, other factors to consider in choosing a treatment center include:
Cost may also be a factor. Most addiction rehab is at least partly covered by health insurance, but if “too expensive” concerns still make it tempting to give up the idea, consider what an untreated addiction will cost in the long term, not only in money spent on the drug itself but in damage to health, relationships, property, and productivity.
Unfortunately, addiction dangers don’t all disappear with detox. As with other chronic illnesses, around half of patients will have at least one subsequent relapse. Some people develop post-acute withdrawal syndrome (PAWS), which can cause periodic depression, insomnia and morphine cravings for months. But with or without these setbacks, the true recovery success stories are those who remain not only sober but personally fulfilled.
To help avoid relapse and recover from any relapses that do occur, long-term recovery from morphine addiction should include regular human support:
Anyone with a morphine addiction disorder, whether or not it began with a legitimate prescription, will likely display some or all of the following symptoms:
If addiction is suspected, the person taking morphine should seek medical advice, the sooner the better. A morphine addiction may soon lead to a ruined life, or to a dangerous overdose. Overdose is typically indicated by:
Call for medical help immediately if such symptoms are observed. Without professional treatment, a morphine overdose can easily cause death through stopped breathing or heart failure. Morphine is among the “natural and semi-synthetic opioids” that caused nearly 15,000 overdose deaths in the United States in 2017.
Fortunately, addiction detox and aftercare have prevented thousands of more such tragedies.
SOURCES
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For related information on opiate detox, see the following articles:
Addiction to Oxycodone, Hydrocodone and Other Opiates: Warning Signs, Effects and Stats
Heroin Detox—Withdrawal Symptoms and Timeline
Hydrocodone Detox Guide—Withdrawal Symptoms and Timeline
Prescription Opiate Detox: What to Expect from Withdrawal and Recovery
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