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Morphine is a pain medication of the opiate family that is found naturally in a dark brown, resinous form, from the poppy plant (Papaver somniferum). It can be taken orally or injected; it is also often smoked.[7][9] It acts directly on the central nervous system (CNS) to increase feelings of pleasure and warm relaxation and reduce pain, and is often abused for this purpose.[7] It can be taken for both acute pain and chronic pain and is frequently used for pain from myocardial infarctionkidney stones, and during labor.[7] Morphine can be administered by mouth, by injection into a muscle, by injection under the skinintravenouslyinjection into the space around the spinal cord, or rectally.[7] Its maximum effect is reached after about 20 minutes when administered intravenously and 60 minutes when administered by mouth, while the duration of its effect is 3–7 hours.[7][8] Long-acting formulations of morphine are available as MS-Contin, Kadian, and other brand names as well as generically.

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Potentially serious side effects of morphine include decreased respiratory effort, vomitingnausea, and low blood pressure.[7] Morphine is addictive and prone to abuse.[7] If one’s dose is reduced after long-term use, opioid withdrawal symptoms may occur.[7] Common side effects of morphine include drowsiness, vomiting, and constipation.[7] Caution is advised for use of morphine during pregnancy or breast feeding, as it may affect the health of the baby.[7][2]

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Morphine was first isolated between 1803 and 1805 by German pharmacist Friedrich Sertürner.[10] This is generally believed to be the first isolation of an active ingredient from a plant.[11] Merck began marketing it commercially in 1827.[10] Morphine was more widely used after the invention of the hypodermic syringe in 1853–1855.[10][12] Sertürner originally named the substance morphium, after the Greek god of dreams, Morpheus, as it has a tendency to cause sleep.[12][13]

The primary source of morphine is isolation from poppy straw of the opium poppy.[14] In 2013, approximately 523 tons of morphine were produced.[15] Approximately 45 tons were used directly for pain, a four-fold increase over the last twenty years.[15] Most use for this purpose was in the developed world.[15] About 70 percent of morphine is used to make other opioids such as hydromorphoneoxymorphone, and heroin.[15][16][17] It is a Schedule II drug in the United States,[16] Class A in the United Kingdom,[18] and Schedule I in Canada.[19] It is also on the World Health Organization’s List of Essential Medicines.[20] Morphine is sold under many trade names.[1] In 2018, it was the 132nd most commonly prescribed medication in the United States, with more than 5 million prescriptions.

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Medical uses

Pain

Morphine is used primarily to treat both acute and chronic severe pain. Its duration of analgesia is about three to seven hours.[7][8] Side-effects of nausea and constipation are rarely severe enough to warrant stopping treatment.

It is used for pain due to myocardial infarction and for labor pains.[23] However, concerns exist that morphine may increase mortality in the event of non ST elevation myocardial infarction.[24] Morphine has also traditionally been used in the treatment of acute pulmonary edema.[23] A 2006 review, though, found little evidence to support this practice.[25] A 2016 Cochrane review concluded that morphine is effective in relieving cancer pain.[26]

Shortness of breath

Morphine is beneficial in reducing the symptom of shortness of breath due to both cancer and noncancer causes.[27][28] In the setting of breathlessness at rest or on minimal exertion from conditions such as advanced cancer or end-stage cardiorespiratory diseases, regular, low-dose sustained-release morphine significantly reduces breathlessness safely, with its benefits maintained over time.[29][30]

Opioid use disorder

Morphine is also available as a slow-release formulation for opiate substitution therapy (OST) in Austria, Germany, Bulgaria, Slovenia, and Canada for addicts who cannot tolerate either methadone or buprenorphine

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