Morphine is a drug derived from the opium poppy.
For many years, doctors have used morphine to treat moderate to severe pain. While pharmaceutical companies have developed newer opioids, morphine remains the gold standard.
Doctors give morphine to patients in different forms as a pain reliever.
There is the intravenous and intramuscular morphine ordered for hospital patients. Morphine also comes in tablet form, prescribed for patients with chronic pain.
Morphine is not only a street drug, but it is also a serious drug of abuse, like other opiate drugs. Heroin is a close relative of morphine. When the body metabolizes heroin, it turns into morphine. If you think about it, heroin is essentially morphine.
What happens when you stop taking morphine that has been given to you by a doctor to treat your pain? If your doctor gives you morphine for pain in the hospital for a few days, you would probably have no issues after they stop giving it to you.
However, if you take morphine at high dosages for long periods, you may have to deal with morphine withdrawal. Morphine withdrawal syndrome is similar to the withdrawal syndrome of other opioids.
People often describe morphine withdrawal symptoms as being like having a bad case of influenza. Yet, as bad as the flu can be, morphine withdrawal is far worse.
Some people have called it the flu times one-hundred.
It is hard to imagine how bad it feels to go through morphine withdrawal symptoms. What will happen to you if you quit using morphine cold turkey? How does the timeline look for opiate withdrawal? What are the morphine withdrawal stages?
In the first 12 hours, the initial symptoms include runny nose, yawning, sweating, and goosebumps. Hot flashes, cold chills, and cold sweats are frequent occurrences.
As the timeline progresses, there will be increasing irritability and anxiety. Blood pressure may go up along with other body changes.
Most people can, with determination, power through the first twenty-four hours of morphine withdrawal. For patients who are going to start Suboxone treatment, this is critical.
Patients cannot begin to take Suboxone until they are in physical opioid withdrawal. The typical waiting period after taking the last dose of morphine to the first dose of Suboxone is 18-24 hours. The waiting period can be more extended for time-release morphine, such as MS Contin.
Between 12 and 24 hours, symptoms worsen.
Muscle aches and muscle cramping, insomnia accompany worsening anxiety and irritability. The patient then develops an upset stomach with nausea. Often vomiting and diarrhea start by the second day.
Some Suboxone patients with prior experience may try to hold off taking the first dose until the gastrointestinal symptoms start. Often, this is a sign that they can safely take Suboxone without worrying about precipitated withdrawal.
Precipitated withdrawal is a sudden worsening of withdrawal symptoms that can occur with a patient takes Suboxone too soon. It is due to the opioid receptor-blocking-action of the ingredient, buprenorphine.
You may have a goal of starting medication-assisted treatment with buprenorphine or naltrexone. Both of these treatment drugs require going through a period of opioid withdrawal. Or, you may plan to quit morphine without taking treatment medication.
There are some essential things to keep in mind when you stop taking morphine.
It would be best if you made preparations to go through the morphine withdrawal stages. Prepare to be hydrated. Especially if you have vomiting and diarrhea, you must drink fluids. If you cannot keep fluids down, go to the hospital. Dehydration is a dangerous condition.
See your doctor as soon as possible.
There are comfort medications that can help you to get through the morphine withdrawal timeline with less discomfort. Clonidine, a prescription medication, is one of the most commonly used meds for the withdrawal symptoms of physical dependence on opiates.
Lucemyra is similar in action to clonidine with fewer side effects. Your doctor may also prescribe other medicines to help with the symptoms.
While withdrawal from morphine is usually not life-threatening or dangerous, you may want to consider going to an inpatient detox program. While the first two days of the morphine withdrawal stages are severe, the worst of it usually happens around day three.
Many people describe the morphine withdrawal timeline as peaking at about 72 hours. At this point in the morphine withdrawal symptoms timeline, all of the symptoms peak in severity. And, many people start to experience severe drug cravings.
Why are cravings a problem at this point on the morphine withdrawal timeline?
When you are physically ill, and all you can think about is using more morphine, you are at high risk for relapse. Your mind will come up with all kinds of plans to get morphine to ease the discomfort and suffering.
Patients who start Suboxone or similar meds usually start before this point in the morphine withdrawal timeline. Therefore, Suboxone patients avoid the worst of morphine withdrawal symptoms.
It is essential to block your access to morphine if you go through all of the morphine withdrawal stages. A residential rehab program will help to keep you safe in this respect.
What happens after the peak of the morphine withdrawal symptoms timeline?
As you can imagine, the symptoms start to improve. Gradually, you will begin to feel better. While you will be through the worst of it after the third day, you are not out of the woods yet. It will still take 7-10 days for the symptoms to fade away.
Many people who quit taking morphine will continue to have withdrawal symptoms for days and even weeks after the last use of morphine. While not as bad as the acute withdrawal symptoms of the first week, these ongoing symptoms are unpleasant. They can come and go and include chills, aches, depression, and irritability. Some people also develop restless leg syndrome (RLS).
What is PAWS?
Long-term symptoms after the withdrawal from morphine are sometimes called PAWS, or post-acute withdrawal syndrome. PAWS can persist for weeks or even months after getting through the early morphine withdrawal stages.
Without ongoing social and professional support, the risk of relapse can be high with PAWS. When morphine withdrawal symptoms persist on and off for many months, it can lead to frustration and the feeling that it will never end.
Of course, PAWS does eventually end if you stay free of opioids. For many patients, it will be mostly over after six weeks. Even if PAWS lasts for many months, it will ultimately end. Rarely does PAWS last as long as a full year.
What about a morphine recovery center?
Would such a recovery center program make the withdrawal from morphine more tolerable? What kind of morphine recovery centers are available?
There are short-term opioid detox programs and residential rehabs. A medical detox facility observes you 24 hours a day, usually for a week or two, while administering medications to make the withdrawal from morphine more tolerable.
A rehab continues the protective function of keeping you off of the streets. During your time in rehab, you will go to group therapy sessions and learn how to deal with triggers. Triggers are things that cause you to have thoughts of using morphine again. You will learn to manage triggers and to avoid them when possible.
At a good rehab, medical professionals will provide medical supervision.
Research treatment programs carefully before making a decision. Quality addiction treatment requires more than just support groups.
What medication-assisted treatment options are available?
Another medication that, like Suboxone, can improve your chances of long-term success, is naltrexone. Naltrexone is a pure opioid blocking medication that comes in an oral tablet form.
You cannot start taking naltrexone until at least a week after your last morphine use. However, if you go to detox and rehab, you may want to visit a doctor when you get out. Ask your doctor if naltrexone is right for you.
Buprenorphine, the active drug in Suboxone, and naltrexone are two of the three drugs available in the US for medication-assisted treatment of opioid use disorder. What is the third medication-assisted treatment medication?
Methadone is the third MAT treatment medication and is considered to be the gold standard. MAT treats the physical and psychological symptoms of opiate dependence and addiction. It is the best form of treatment to prevent relapse.
Methadone has one significant advantage over the other two options. You can start taking methadone the same day that you quit morphine. You can avoid the morphine withdrawal timeline altogether.
If the morphine withdrawal stages are so severe, why doesn’t everyone go to the methadone clinic to get off of morphine and other opioids?
The trade-off is that methadone clinics require patients to come in every day to get their daily methadone dose. Methadone clinics require regular daily visits because methadone is such a dangerous drug. Suboxone, on the other hand, can be prescribed monthly. So, if you can power through the first 24 hours or so of morphine withdrawal symptoms, you can choose Suboxone treatment over methadone in most cases.
For the best chance of success in overcoming morphine addiction, see your doctor.
Morphine withdrawal symptoms are severe and should not be faced alone. While the symptoms themselves are not life-threatening in most cases, this does not take away from the extreme unpleasantness of the experience. I recommend that you see a doctor for medical treatment to give you the best chance of success and to help you get back to normal functioning as soon as possible.