- Generic Name or Active Ingridient: Morphine
Morphine is a powerful opioid pain reliever made from the opium poppy plant. Doctors prescribe morphine to relieve moderate to moderately severe pain.
Morphine and other opioids work with the nervous system to change the way the brain interprets pain signals. Opioids make other neurological changes that can have immediate or long-lasting effects. Morphine causes sedation and a pleasant sense of euphoria; long-term use can cause neurological changes, affecting the way a person thinks, feels and behaves. These cognitive, emotional and behavioral changes can adversely affect the individual’s ability to work, take care of family or interact with others.
Most people take morphine as directed but some take it for non-medical reasons, either to get high or to treat a condition other than the one the doctor had intended to treat. Each year, about 5 million Americans use painkillers like morphine for non-medical reasons.
Anyone who uses morphine regularly for therapeutic or non-medical reasons can become dependent on opioids and suffer uncomfortable withdrawal symptoms when he stops using morphine. At any given point, about 2 million Americans are opioid-dependent and will need to eventually undergo detoxification to achieve a drug-free state.
The human body adapts to the presence of morphine, eventually depending on having a certain level of morphine to feel normal. When morphine levels drop drastically, the opioid-dependent body struggles to regain chemical stability. Doctors refer to this as detoxification.
The individual feels this struggle for detoxification through withdrawal symptoms, which begin a few hours after the last dose of morphine. Uninterrupted, these withdrawal symptoms last for several days before fading as the body completes the morphine detoxification process.
Morphine detoxification can also refer to the medical process of controlling withdrawal symptoms. Physicians prescribe medications to control the onset of detoxification or reduce withdrawal symptoms enough for the patient to complete the detoxification process.
Morphine detoxification is just one part of the recovery process and, by itself, does little to change the behaviors associated with drug abuse. Rehabilitation including counseling and behavior modification helps the individual learn to live without drugs. Together, detoxification and rehabilitation reverse the neurological changes associated with drug abuse and work towards restoring the individual to his former life.
Types of Detox
People experience opioid dependence in a wide variety of ways. Some become dependent when using morphine as directed to treat chronic pain while others start out using morphine to get high. One person may be able to refuse drugs when offered, compared to another individual who gets high at every opportunity.
To address the widespread need for treatment, medical professionals have devised several approaches to detoxification. A patient may now try morphine detoxification at home or at a specialty facility, such as an inpatient hospital, inpatient or outpatient rehabilitation facility or mental health center. Of those who needed to undergo morphine detoxification, only 10 percent got help from one of those specialty facilities. Others engaged in self-help or got professional help from a private physician, in an emergency room or while in jail.
These are all viable choices, each with its own benefits and drawbacks. Treatment choice depends heavily on individual needs. One person may complete morphine detoxification without a lot of anti-withdrawal drugs or supervision while another might require hospitalization and around-the-clock care
Doctors often care for patients who need to take morphine for a long time to relieve pain from a chronic condition. When it is time for the patient to discontinue morphine, physicians usually recommend the patient wean himself by taking smaller doses each day.
Many patients try to quit “cold turkey” by stopping morphine use suddenly. This allows opioid levels to crash; the patient experiences the full brunt of withdrawal symptoms. Quitting cold turkey does bring the patient to a drug-free state.
The phrase “cold turkey” refers to the appearance of the patient’s skin during the detoxification process: pale, cold and clammy with goose bumps. This fades as the patient completes morphine detoxification.
Many individuals seek out natural detoxification remedies, including acupuncture, meditation, yoga and massage. Others use a nutritional approach, consuming only certain herbs, vegetables, fruits, soups and juices to help the body naturally detoxify itself. Ginger and peppermint relieve nausea, for example, while chamomile and cayenne curb diarrhea.
Self-medication methods such as The Thomas Recipe.
Includes a benzodiazepine such as Valium, Librium, Ativan or Xanax for anxiety and insomnia. Imodium for diarrhea, L-Tyrosine for malaise, Vitamin B6 and supplements along with hot baths for muscle aches and restless leg syndrome.
Outpatient detoxification is appropriate for those patients that have been dependent on opioids for more than a year and who require little supervision. As with other types of care, healthcare providers take a comprehensive approach including medicines and psychotherapy including behavior modification.
Usually done with replacement Drugs: Such as Methadone, Suboxone, Subutex and or Buprenorhine.
Sometimes outpatient clinics will administer methadone or buprenorphine as a “step down” drug to ease withdrawal symptoms in patients attempting detoxification at home. Doctors refer to this as medication-assisted treatment or medically supervised withdrawal. Patients start out on a high dose of the replacement drug during the induction phase and reduce the daily dosage over the course of several days or weeks during the tapering phase.
German laboratories first synthesized methadone in 1939 as a pain reliever. In 1964, doctors developed methadone as a response to an epidemic of heroin use sweeping across New York City. The FDA approved methadone for use in the treatment of opioid dependence in 1972.
About 100,000 Americans use a methadone maintenance program. Methadone patients come to the methadone clinic for a drink containing methadone. The effects of methadone last 24 to 36 hours. Some methadone clinics offer services including vocational and educational aid, referrals to other services, support for family members and treatment for co-existing substance abuse problems.
Taken three times a week under the tongue. Doctors who receive advanced training have been able to prescribe buprenorphine for home use through local offices since 2002. There is a risk for abuse from recreational users who dissolve and inject buprenorphine. Since 2002, the FDA has allowed doctors to write buprenorphine prescriptions for take-home use. According to early rules, patients had to be in treatment for nine months before they could take home a one-week supply of buprenorphine. The Department of Health and Human Services eased restrictions even more in 2013, allowing new patients to take home enough buprenorphine to last a week or more.
Some patients use buprenorphine as part of medically supervised withdrawal. While there is no set tapering schedule, some patients can complete detoxification in as little as one week, spending the first one to three days in the induction phase and tapering during days four through seven.
Suboxone and Subutex
Suboxone and Subutex are brand name preparations of buprenorphine that also contain naloxone, sometimes referred to as Narcan, which has little effect when dissolved under the tongue but neutralizes the effects of buprenorphine when injected.
Treat the individual symptoms of the withdrawal with a non opiate medication. One medication is given for anxiety, another for nausea, another for diarrhea, and another to decrease a derivative of adrenaline that becomes elevated during withdrawal. The benefit of this approach is that the withdrawal is less uncomfortable than quitting cold turkey and is not prolonged through the use of substitute opiate medications.
Inpatient treatment is appropriate for those who:
have suffered an overdose and cannot receive treatment safely in an outpatient setting.
Are at risk for severe withdrawal symptoms or complications
Have co-existing conditions that make outpatient detoxification unsafe
Have a documented history of not engaging in or benefiting from less restrictive programs
Have psychiatric problems that impair his ability to participate in treatment, including depression with suicidal thoughts or acute psychosis.
Exhibit behaviors that may cause danger to himself or others
Have not responded to less restrictive forms of treatment and suffers opioid dependence severe enough to pose a threat to the patient or others
Rapid Opiate Detox
Rapid opiate detox is a safe and effective procedure that rids the body of opiates while the patient rests in a comfortable “twilight sleep.”
Our detox center: Who we are and what we do
Fully accredited hospital, board-certified anesthesiologists, other medical professionals deliver compassionate and effective care for more than a decade.
Treat patients as people, not as drug addicts.
Pre-screening in an accredited facility for pre-existing conditions that undermine success. Create a treatment plan according to the patient’s personal needs. Complete detoxification. Follow up in an aftercare facility.
Self-detoxification is the least expensive and most private. Associated with most risk for complications due to uncontrolled withdrawal symptoms.
Outpatient maintenance is better than self-detoxification in that it offers replacement drugs and counseling. Outpatient care reduces the risk for complications. Patients remain in treatment for months or years.
Inpatient care is better because it offers complete detoxification before the individual engages in rehabilitation. Inpatient care offers more monitoring. Completion rates are highest for detoxification services - about 66 percent - and lowest for outpatient treatment at about 42 percent. Only about 14 percent of those participating in outpatient medication-assisted therapy with methadone or buprenorphine complete treatment.
The average length of stay for detoxification is 4 days, compared with 197 days for medication-assisted therapy.
Rapid detox is the most humane and efficient approach, offering fast and complete detoxification. Rapid detox brings the patient to a drug-free state in hours rather than days or months. Rapid detox frees the patient from the uncomfortable and demoralizing withdrawal symptoms that interfere with recovery.
Detox Possible Complications
Morphine detoxification is not typically a life-threatening procedure but withdrawal symptoms, chronic substance abuse, and underlying medical conditions may cause dangerous complications.
Vomiting and diarrhea may result in dehydration and imbalances of potassium, sodium and other electrolytes. Morphine detoxification may cause withdrawal symptoms such as increased blood pressure, rapid pulse and sweating, which may worsen underlying heart conditions. Withdrawal may cause fever. The detoxification process may cause the patient to feel anxious, which can worsen a pre-existing anxiety disorder. Detoxification may cause pain to return in patients who took morphine to control long-term discomfort associated with chronic diseases like cancer or arthritis.
Relapse is the primary complication associated with morphine detoxification. Some patients take more morphine to stop withdrawal symptoms during the detoxification process while others relapse weeks or months later because they have not learned how to live without drugs.
Relapse increases the risk for an overdose. The detoxification process reduces the individual’s tolerance to morphine, making him more sensitive to the effects of opioids. Because of this reduced tolerance, it is possible for someone to overdose on a smaller amount of morphine than he used to take before experiencing even modest withdrawal symptoms. In 2008, 14,800 Americans died from overdoses of opioid painkillers like morphine.
Self Detox Possible Complications
Without anti-withdrawal medications, screening for pre-existing conditions or professional guidance, those who try self-detoxification experience the full brunt of withdrawal symptoms and face an increased risk for complications. Self-detox patient have a greater likelihood of suffering dehydration, electrolyte imbalances, relapse and complications due to previously undiagnosed illnesses.
Outpatient Care Possible Complications
Patients who receive methadone, buprenorphine or brand name replacement drugs may suffer complications associated with those drugs.
Some patients find it difficult to quit the replacement drugs at the appropriate time. About half of all methadone users go on and off methadone treatments for the rest of their lives.
Methadone is not entirely safe: it accounts for about one-third of opioid pain reliever deaths, up six fold in ten years, even though methadone sales account for only 2 percent of the prescription painkiller market. The number of deaths associated with methadone is rising; in 2009, there were 5.5 times as many deaths associated with methadone as there were in 1999.
Some individuals abuse methadone and buprenorphine to get high.
Inpatient Detox Possible Complications
With anti-withdrawal drugs, specially trained staff, prescreening and advanced medical care including heart monitoring and intravenous fluids, inpatient care provides the greatest protection against complications. Some patient may still have difficulties during morphine detoxification, usually associated with pre-existing conditions and co-existing substance abuse disorders.
Rapid Detox Possible Complications
Rarely, patients have an allergic reaction to the drugs used in rapid detox procedures. Strong sedatives may cause problems with breathing, pulse and blood pressure. Someone receiving intravenous anesthesia drugs may suffer bruising, swelling or infection at the injection site.
Despite decades of medical research and mountains of information revealed by rehabilitation professionals and real patients, myths surrounding morphine detoxification still prevent an untold number of people from getting the help they need. Patient education opens a world of possibilities to the opioid-dependent individual.
Self Detox Myths
Myth: Self-detoxification is just a matter of will power - anyone can do it.
Fact: Morphine detoxification is an intense physiological process causing real pain and severe symptoms. While some people are able to wean themselves from morphine without the help of medical professionals, severe withdrawal symptoms, dangerous complications and pre-existing illnesses make self-detoxification dangerous for others.
Myth: Home remedies like The Thomas Recipe are safe and effective because they incorporate prescription and non-prescription drugs into a treatment plan.
Fact: Mixing prescription and non-prescription drugs can cause dangerous drug interactions or unexpected results. These drugs can be dangerous for those suffering complications or who have pre-existing conditions.
Outpatient Detox Myths
Myth: It would be cheaper to toss drug abusers in prison than to provide treatment.
Fact: A one-year supply of methadone costs about $4,700 per patient whereas a year of imprisonment costs a community approximately $24,000 per prisoner.
Myth: Methadone rots your bones and teeth.
Fact: Inadequate methadone doses may cause bone ache, a symptom of methadone withdrawal; increasing dosages should resolve bone ache. Methadone can cause a dry mouth in some patients; a dry mouth promotes plaque, which leads to tooth decay and gum disease - patients should drink more water and remember to brush and floss daily.
Inpatient Detox Myths
Myth: Morphine detoxification is a waste of time - opioid-dependent people always relapse.
Fact: Relapse rates for drug addiction are 40 to 60 percent, similar to other conditions such as high blood pressure, diabetes and asthma.
Myth: Spending money on morphine treatment is like throwing money down a hole.
Fact: A community can expect a return of $4 to $7 in reduced drug-related crime rates, criminal justice costs and theft for every dollar spent for drug treatment. Add in savings to healthcare costs and these yields jump to $12 gained for every dollar spent.
Rapid Detox Myths
Myth: Suffering is an important part of the treatment process, as it acts as a deterrent to future substance abuse.
Fact: Human suffering is not an appropriate part of any treatment plan. In fact, the uncomfortable and demoralizing withdrawal symptoms associated with morphine detoxification prevent many from quitting this drug. Rapid detox offers a humane approach to medical detoxification, allowing patients to enjoy a pleasant twilight sleep instead of enduring endless days of detoxification.
Myth: Medical detoxification takes days or weeks to perform.
Fact: It takes a reputable expert one to two hours to perform rapid detox, which brings the patient to an opioid-free state.
Detox and Pregnancy
Opioid-dependence puts a woman at special risk of certain medical disorders, such as anemia, blood infections, heart disease, diabetes, and pneumonia. These conditions increase the risk for complications during pregnancy, labor and delivery making morphine detoxification unsafe for pregnant women. For example, a woman might suffer hemorrhage and uncontrolled bleeding, inflammation or separation of the tissue surrounding the baby, slow fetal growth, premature labor and delivery, spontaneous abortion and fetal death.
Methadone reduces these complications and is currently the only approved approach to treating opioid dependence in pregnant women.
Self Detox and Pregnancy
A woman should never attempt self-detoxification while pregnant, as complications may pose a danger to her health or the health of the baby.
Outpatient and Pregnancy
A pregnant woman may begin methadone treatments as an outpatient, usually starting with 10 - 20 mg of methadone. Her doctor may increase the dosage 5 to 10 mg each day until she determines a safe and effective dose, not to exceed 60 mg of methadone daily. Physicians will monitor her condition closely for the first 48 to 72 hours.
An opioid-dependent woman may become more tolerant to methadone and require higher doses to control withdrawal symptoms late in pregnancy. Her physician will again adjust her doses to provide safe, effective protection.
Babies born to women taking methadone during pregnancy will remain under close observation in the hospital for 72 hours after delivery.
Inpatient and Pregnancy
A pregnant woman may prefer to start methadone treatments as an inpatient where doctors and nurses can monitor her health as well as observe the baby’s response to treatment. This inpatient stay usually lasts about three days before discharge to an outpatient care provider.
Opiate detox symptoms
Symptoms of morphine detoxification often appear in two phases, with the first set of symptoms beginning a few hours after the last dose of morphine. Initially, the patient may have trouble sleeping and feel agitated or anxious. He may have watery eyes, a runny nose, achy muscles, and seem to sweat excessively and yawn frequently. Later, he might suffer a stomachache, diarrhea, nausea and vomiting. His pupils may appear dilated and he might have pale, cold and clammy skin with goose bumps.
What is the best method to detox from this drug?
The best method of morphine detoxification depends largely on the patient’s individual needs, and is usually the one that offers the most flexibility and still provides safe, effective care. He should assess his own ability to refrain from drug use and his need for structure and support then choose a program that fits those needs. The treatment should reflect the patient’s ability to cooperate with and benefit from the type of treatment offered, and it should be readily available to promote participation and completion.
Please contact us for more information on what form of morphine detoxification is right for you or your loved one.