Morphine Addiction: Definition, Causes, symptoms, effects, and treatment methods

Morphine addiction is a disorder that causes an individual to be dependent on the opioid drug morphine. Morphine addiction has various causes including medical prescriptions (chronic pain relief), environmental factors, psychological factors, genetic predisposition, and changes in brain chemistry.

The symptoms of morphine addiction include yen sleep, runny nose, slurred speech, itchy skin, euphoria, mood swings, secretive behavior, paranoia, anxiety, and depression.

The short-term and long-term effects of morphine addiction are euphoria, sedation, constipation, respiratory depression, hormonal imbalance, organ damage (liver), overdose and risk of death, mental health disorder (neurological disorder), altered brain chemistry, auditory hallucinations, and paranoia.

Some of the most common treatment options for morphine addiction are detoxification, cognitive behavioral therapies, medication-assisted treatment, long-term rehabilitation programs(in-patient/ out-patient), and support groups.

What is Morphine Addiction?

Morphine addiction is an opioid use disorder that causes compulsive use of morphine which is an opioid analgesic, despite its harmful consequences. Morphine addiction is classified as a chronic recurrent disease of the central nervous system that leads to personality disorders, comorbidities, and premature death, according to the study titled: “The Mechanisms Involved in Morphine Addiction: An Overview” by Joanna Listos.

In the United States, morphine is classified as a Schedule II drug under the Controlled Substances Act, as it brings a high risk of addiction development but has medical uses as well. Some other common names of morphine are Dreamer, Emsel, MST, Zomoprh, MXL, and Sevredol.

How is Morphine Consumed?

Morphine is consumed through oral ingestion, inhalation, and injection. Oral ingestion involves consuming tablets or liquid solutions containing morphine which are absorbed by the digestive system. Inhalation is crushing morphine and snorting it through the nose. Injection involves directly injecting the drug into the bloodstream.

How Common is Morphine Addiction?

Morphine addiction is a significantly common issue worldwide, especially in the United States. Drug overdose deaths involving heroin rose from 3,036 in 2010 to 15,469 in 2016. Since 2016, the number of deaths has trended down with 13,165 deaths reported in 2020, 9,173 reported deaths in 2021, and 5,871 reported deaths in 2022, according to the statistics by the National Institute on Drug Abuse.

What are the Causes of Morphine Addiction?

The causes of morphine addiction include medical prescriptions for chronic pain relief, environmental factors, psychological factors, genetic factors, changes in brain chemistry, and social isolation.

These causes are described below.

• Medical Prescriptions for Chronic Pain Relief: Morphine is regularly used for pain relief, and prolonged use leads to dependence and tolerance. People usually misuse prescribed medicines that contain morphine and develop a chronic addiction.

• Environmental Factors: Environmental factors like staying with people who abuse morphine and other substances cause an individual to indulge in opioid usage. Individuals in high-stress or drug-prone environments are more likely to misuse opioids like morphine, according to a study titled: “Meta-Analysis of Individual and Environmental Factors that Influence People’s Addiction Tendencies” by Saideh Safari Hajat Aghaii.

• Psychological Factors: Psychological factors like emotional stress, depression, and anxiety lead to morphine addiction. People often abuse opioid substances to relieve the symptoms of mental health issues and eventually develop an addiction that later causes more problems like emotional pain and trauma.

• Genetic Factors: Genetic factors are having a family history of opioid usage. A major fraction of the opioid addiction risk is genetic in origin and 54% of the liability for opioid addiction was due to genetic variance, according to a study titled: “A brief review of the genetics and pharmacogenetics of opioid use disorders” by Wade Berrettini.

• Changes in Brain Chemistry: Changes in brain chemistry occur during the first stages of repeated use of morphine. The brain’s reward system develops a tolerance for the drug and people don’t feel the same effects as they used to, causing them to abuse the substance even more.

• Social Isolation: Social isolation causes an individual to develop feelings of loneliness and lack of social support, which often makes them vulnerable to morphine addiction. The endogenous opioid system provides a psychobiological mechanistic explanation for the role of social connectedness in addiction, according to research titled: “The role of social isolation in opioid addiction” by Nina C Christie.

What are the Symptoms of Morphine Addiction?

The symptoms of morphine addiction include a combination of physical, behavioral, and psychological signs. These symptoms fall under the criteria provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

These signs and symptoms of morphine addiction are listed below.

Physical Symptoms of Morphine Addiction

The physical symptoms of morphine addiction are listed below.

• Yen Sleep: Yen sleep is laziness and falling asleep more than usual.  It has been shown that drug use may trigger the induction of sleep disturbances, and those suffering from difficulties in sleeping are prone to relapse to drug use, including opioids, according to a study titled: “Crosstalk between Sleep Disturbance and Opioid Use Disorder: A Narrative Review” by Hamid Reza Fathi.

• Runny Nose: Runny nose and other nasal symptoms are often related to chronic morphine usage when the body has difficulty adjusting to the drug. Individuals exhibit nasal congestion, runny nose, and frequent sneezing during morphine withdrawal, according to a study titled: “Morphine addiction: symptoms, signs, effects, causes, and treatment” by Asif Baliyan.

• Slurred Speech: Slurred speech occurs when chronic morphine usage impacts the central nervous system, which slows down cognitive and motor functions. This causes paralyzed speech and individuals have a hard time controlling their lips, tongue, vocal cords, and diaphragm.

• Itchy Skin: Itchy skin occurs when constant morphine usage triggers the body’s histamine release and causes skin problems. Morphine causes dilatation of cutaneous blood vessels; the skin of the face, neck, and upper thorax may become flushed according to research titled: “Opioid-Induced Itching: Morphine Sulfate and Hydromorphone Hydrochloride” by Jerald Katcher MD.

Behavioral Symptoms of Morphine Addiction

The behavioral symptoms of morphine addiction are listed below.

• Euphoria: Euphoria occurs when morphine stimulates the brain’s reward system and creates intense feelings of pleasure and well-being. Activation of the μ-opioid receptor by an agonist such as morphine causes euphoria and an intense feeling of pleasure, according to research titled: “Neuropathology of Drug Addictions and Substance Misuse” by Jahangir Moini.

• Mood Swings: Mood swings occur when an individual is not using the drug, causing dramatic shifts in mood, irritability, and depression. Incidence studies showed that people who used prescription opioids had an elevated risk of any mood outcome, according to a study titled: “Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies” by Janni Leung.

• Secretive Behavior: Secretive behavior occurs when individuals with morphine addiction often try to hide their drug use and avoid questions about their activities. They don’t share their feelings with anyone and try to avoid any social interaction.

Psychological Symptoms of Morphine Addiction

The psychological symptoms of morphine addiction are listed below.

• Paranoia: Paranoia occurs due to prolonged morphine usage, causing an individual to feel a loss of trust and fear. This mainly occurs due to alterations in brain chemistry and causes feelings of suspicion and other delusional beliefs.

• Anxiety: Anxiety is almost certain during morphine addiction as it occurs both when using the drug and avoiding it. A link was found between prescription opioid use and negative mental health consequences such as anxiety, according to research titled: “Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies” by Janni Leung.

• Depression: Depression is caused when constant morphine usage disrupts the brain’s natural balance of dopamine and serotonin. Opioid addiction frequently results in depressive symptoms, as the brain becomes reliant on the drug for mood regulation, according to a study titled: “Prescription Opioid Analgesics Increase Risk of Major Depression: New Evidence, Plausible Neurobiological Mechanisms and Management to Achieve Depression Prophylaxis” by Katherine Semenkovich.

How can morphine addiction lead to Opioid Use Disorder (OUD)?

Morphine addiction leads to opioid use disorder as it alters the brain’s reward system and causes compulsive drug-seeking behavior, building a dependence on the drug. Morphine tends to bind to an individual’s opioid receptors in the brain, building up a tolerance and causing both physical and psychological dependence.

Opioid use disorder is a major problem in the United States as morphine addiction becomes more common. At least 2 million people in the US have an opioid use disorder (OUD) involving prescription opioids, according to a study titled: “Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use” by Phillips JK.

An estimated 3% to 19% of people who take prescription pain medications develop an addiction to them, according to a study by the American Medical Association (AMA).

What are the Effects of Morphine Addiction?

The effects of morphine addiction include short-term (euphoria, sedation, and constipation), long-term physical (respiratory depression, hormonal imbalance, and organ damage), and long-term psychological effects (mental health disorders, paranoia, and altered brain chemistry).

These effects are described below.

Short-Term Effects

The short-term effects of morphine addiction are euphoria, sedation, constipation, and nausea.

These effects are listed below.

• Euphoria: Euphoria is a feeling that is produced when morphine and other opioids trigger the brain’s reward system and cause intense senses of pleasure and relaxation. Activation of the μ-opioid receptor by an agonist such as morphine causes euphoria and an intense feeling of pleasure, according to a study titled: “Neuropathology of Drug Addictions and Substance Misuse” by Jahangir Moini.

• Sedation: Sedation is caused when morphine depresses the brain’s central nervous system, producing feelings of laziness and drowsiness. This impact makes an individual feel relaxed but tends to impair the cognitive and motor functions of the brain.

• Constipation: Constipation occurs when compulsive morphine usage slows down the body’s gastrointestinal motility and causes digestion problems. Opioid-induced constipation (OIC) accounts for over 40% to 60% of patients without cancer receiving opioids, according to the study titled: ”Opioid-Induced Constipation” by Omeed Sizar.

• Nausea: Nausea is caused when morphine affects the brain’s chemoreceptor trigger zone, causing intense feelings of vomiting and sickness. A systematic review of randomized controlled trials of opioids for chronic noncancer pain reported that 32% of patients developed nausea and 15% developed vomiting, according to research titled: “Opioid-induced nausea and vomiting” by the Albany Medical College.

Long-Term Physical Effects

The long-term physical effects of morphine addiction are respiratory depression, hormonal imbalance, organ damage, and overdose risk.

These effects are listed below.

• Respiratory Depression: Respiratory depression is dangerously slow or shallow breathing. Individuals with chronic morphine addiction damage their respiratory organs and tend to suffer from breathing problems. Respiratory depression (RD) is the primary cause of death due to opioids, according to titled: “Current research in pathophysiology of opioid-induced respiratory depression, neonatal opioid withdrawal syndrome, and neonatal antidepressant exposure syndrome” by Brian A Baldo.

• Hormonal Imbalance: Hormonal imbalance is a disruption in the body’s hormonal imbalance. Morphine addiction causes hormonal imbalance by suppressing the testosterone and estrogen levels in an individual’s body. In humans and laboratory animals, opioids generally increase GH and prolactin and decrease LH, testosterone, estradiol, and oxytocin, according to the journal “Endocrine Reviews Volume 31.”

• Organ Damage(liver): Organ damage caused by morphine addiction negatively impacts the liver and other essential organs, which often leads to respiratory failure.  Overdoses of the more potent opioids like morphine have been linked to cases of acute liver injury, according to a study titled: “Opioids, Opioid Antagonists” by the  National Institute of Diabetes and Digestive and Kidney Diseases.

• Overdose Risk: Overdose risk rises when the body develops a tolerance for morphine usage and the individual does not feel the same effects as they used to. This forces them to take more or heavier doses, eventually further damaging their health and overdosing.

Long-Term Psychological Effects

The long-term psychological effects of morphine addiction are mental health disorders (Neurological Disorders), altered brain chemistry, auditory hallucinations, and paranoia.

These effects are listed below.

• Mental Health Disorders (Neurological Disorders): Mental health and neurological disorders like anxiety, depression, and stress are linked to long-term morphine usage.  A link was found between prescription opioid use and negative mental health consequences such as anxiety, according to research titled: “Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies” by Janni Leung.

• Altered Brain Chemistry: Altered brain chemistry is caused by changes in the brain’s natural chemical balance due to prolonged morphine addiction. It reduces the brain’s ability to produce dopamine and serotonin. Brain abnormalities resulting from chronic use of morphine-derived drugs are underlying causes of opioid dependence, according to a study titled: “The Neurobiology of Opioid Dependence: Implications for Treatment” by Thomas R Kosten.

• Auditory Hallucinations: Auditory hallucinations are hearing sounds and voices that are not physically present. Individuals with morphine addiction suffer from this as the opioid has negative effects on the sensory processing of the brain.

• Paranoia: Paranoia occurs when an individual starts building up feelings of distrust, suspicion, and fear due to prolonged morphine addiction. People have a hard time socializing and develop a fear of talking and sharing feelings with others.

What are the Treatment Methods for Morphine Addiction?

The treatment options for morphine addiction include detoxification, cognitive behavioral therapy, medication-assisted treatment, long-term rehabilitation programs, support groups, and holistic therapies.

These treatment methods are listed below.

• Detoxification

• Cognitive Behavioral Therapy

• Medication-Assisted Treatment

• Long-term rehabilitation programs (in-patient/ out-patient)

• Support Groups

• Holistic Therapies

Detoxification

Detoxification is the initial stage of treatment when the morphine addiction starts wearing off under professional medical supervision. Patients stay supervised 24/7, and professionals help them control their urges and symptoms.

It is effective when controlling withdrawal symptoms but it does not help manage the psychological dependency that builds up over time. Detoxification takes up to two weeks, depending on the condition of the patient.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is consulting a professional to change negative thought patterns and behaviors developed from drug use. CBT is highly versatile as it offers therapy for both individuals and groups and it reduces relapse risk. It’s important to keep in mind that CBT is time-consuming.

The treatment takes 12-16 weeks depending on the plan. CBT counseling is effective in reducing opiate use improving employment function and decreasing stress levels, according to research titled: “Efficacy of Cognitive Behavioral Therapy on Opiate Use and Retention in Methadone Maintenance Treatment in China” by Shujun Pan and Haifeng Jiang.

Medication-Assisted Treatment

Medication-assisted treatment is using pharmaceutical medicines like methadone, buprenorphine, and naltrexone for morphine addiction treatment. It is a highly effective treatment and it reduces the risk of relapse. It requires intense supervision and causes dependency on the medication itself.

Medication-assisted treatment takes 6-12 months, depending on the individual’s needs. Methadone is associated with better retention in treatment and greater patient satisfaction than other medications for OUD, according to a study titled: “The Effectiveness of Medication-Based Treatment for Opioid Use Disorder” by the National Academics Press (US).

Long-term rehabilitation programs (in-patient/ out-patient)

Long-term rehabilitation in-patient programs provide individuals with 24/7 care in a fixed setting, while outpatient programs provide a more flexible treatment plan, allowing patients to stay at home and come to the treatment whenever needed. These rehab programs are good for intensive care, but they can be very costly and time-consuming.

Long-term rehabilitation takes 1-3 months, depending on the situation and the plan. Rehab is effective for treating substance use disorders and overdose, including medications such as opioid use disorder, according to the National Institute on Drug Abuse.

Support groups

Support groups are gatherings of individuals who share the same problems like morphine addiction and they share treatment options and coping mechanisms with each other. These groups are beneficial and free resources for addiction treatment. However, it may not be as effective as other treatments.

Support groups don't have a time duration for recovery as they are just ongoing resources that people are able to attend. Peer support groups included in addiction treatment show much promise, according to research titled: “Benefits of peer support groups in the treatment of addiction” by Kathlene Tracy.

Holistic Therapies

Holistic therapy methods like yoga, acupuncture, and art therapy relieve stress and improve an individual’s emotional well-being. These therapies positively impact an addict’s life as they provide them with relaxation and activity to distract themselves from their problems.

Holistic therapy is highly beneficial and a great non-pharmacological treatment for morphine addiction, but it is not sufficient enough for severe cases and other medical attention needs to be incorporated into the treatment.

What are the Withdrawal Symptoms of Morphine Addiction?

The withdrawal symptoms of morphine addiction are negative emotions, stress, irritability, insomnia, sweating, and muscle aches. Morphine withdrawal is the physical and psychological response of the body to suddenly reducing or stopping morphine use after prolonged use.

The common morphine withdrawal symptoms are listed below.

• Negative Emotions: Negative emotions such as anxiety, depression, or sadness are common as the brain adjusts to lower dopamine levels.

• Stress: People experience physical and emotional stress when the body struggles without morphine. Stress is managed through relaxation techniques, such as deep breathing or yoga.

• Irritability: People feel angry or easily frustrated due to chemical imbalances in the brain after quitting morphine use.

• Insomnia: Insomnia means difficulty in sleeping, which is a common morphine withdrawal symptom and lasts for several days to weeks. Doctors may prescribe natural sleep aids or herbal teas during this phase.

• Sweating: Increased sweating is common as the body detoxifies from morphine. Staying hydrated and wearing breathable clothing makes this symptom more manageable.

• Muscle Aches: People experience muscle aches and physical discomfort when they withdraw themselves from morphine. Mild pain relievers and hot baths provide relief to relieve the symptoms.

What are the Risk Factors of Morphine Addiction?

The risk factors of morphine addiction include prolonged or high dosage, age, and accessibility. Extended or high-dose morphine prescriptions, especially for chronic pain, increase the risk of addiction and lead to higher tolerance and doses over time, according to the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.

Individuals in late teenage and early adulthood are at higher risk because they are more curious about drugs, addiction, and trying out new things. People with easy access to morphine have a higher chance of addiction as well.

How does Morphine Addiction Relate to Other Substance Addictions?

Morphine addiction relates to other substance addictions, as it activates the brain’s reward system like other drugs. Morphine acts on the brain’s opioid receptors and gives pain relief and euphoria like other opioids, such as heroin or prescription painkillers. This effect leads people to continue using it, despite harmful impacts on health and daily life.

Can morphine and cocaine produce feelings of euphoria?

Yes, both morphine and cocaine can produce feelings of euphoria but through different ways. Morphine acts on opioid receptors to block pain and release dopamine. Cocaine stimulates dopamine release and gives an intense, short-lived euphoria that leads to cocaine addiction.

Is the addiction potential of fentanyl higher than that of morphine?

Yes, the addiction potential of fentanyl is higher than morphine. Fentanyl is much more potent and acts on the brain's opioid receptors at up to 100 times the strength of morphine, which makes fentanyl addiction more potent.

Are morphine and heroin derived from opium?

Yes, both morphine and heroin are derived from opium. Morphine is a natural component of opium, while heroin is a synthetic version of morphine. This relationship makes heroin addiction similar to morphine addiction, as both drugs act on the brain’s opioid receptors to produce pain relief and euphoria.