Morphine 101 | KNIGHTS OF COMFORT

MORPHINE...

A
MEDICINE
WITH A
BAD RAP.

morphine;

Narcotic

Analgesic

Painkiller

Potent

Opioid

IT'S GOES WAY BACK

Morphine, a powerful opioid analgesic, has a long and fascinating history dating back thousands of years. The opium poppy, from which morphine is derived, has been cultivated since ancient times, and its medicinal properties were recognized by various civilizations. However, it was not until the early 19th century that the active ingredient in opium was isolated and named morphine, after Morpheus, the Greek god of dreams. The German pharmacist Friedrich Sertürner is credited with this discovery in 1804, marking a significant milestone in the history of pain relief.

Morphine quickly gained recognition for its potent pain-relieving effects, and its use spread rapidly throughout the medical community. It became widely used during the American Civil War to manage severe pain and suffering among wounded soldiers.

The history of hospice care, which focuses on providing compassionate care for terminally ill patients, is closely intertwined with the use of morphine. The modern hospice movement emerged in the 1960s, with Dame Cicely Saunders pioneering the concept of holistic end-of-life care. Morphine played a crucial role in alleviating pain and improving the quality of life for patients in hospice settings.

From a clinical pharmacology standpoint, morphine acts primarily on mu-opioid receptors in the central nervous system, exerting potent analgesic effects and reduces the perception of pain.

In addition to its analgesic properties, morphine has other beneficial effects in hospice care such as relieving dyspnea (shortness of breath) caused by conditions like congestive heart failure or chronic obstructive pulmonary disease.

Pain;

Is not fun

Can be treated

Can be spoken about

Is our specialty

Is individual

We will fight it together

SO IT SHOULD BE AVOIDED??

It is important to address these misconceptions with evidence-based practice and research to ensure that patients receive appropriate and effective pain management.

One common misconception is that morphine hastens death. However, multiple studies have shown that properly administered morphine does not shorten life expectancy. In fact, effective pain management with opioids like morphine can improve the quality of life for terminally ill patients by alleviating suffering and allowing them to engage in meaningful activities.

Another misconception is the fear of addiction and tolerance to morphine. While opioids can be addictive when used improperly or in non-medical settings, the risk of addiction in patients receiving morphine for pain management in a hospice setting is extremely low. Patients with terminal illnesses are typically using morphine for pain relief, not to achieve a euphoric or recreational high. Additionally, tolerance to opioids can develop over time, requiring higher doses for the same pain relief. However, this is a normal physiological response and does not indicate addiction.

Some individuals worry that morphine may suppress respiration and cause respiratory depression. However, when morphine is used properly and titrated to an individual's pain level, the risk of respiratory depression is minimal. Healthcare professionals closely monitor patients receiving morphine to adjust the dosage as needed and ensure safety.

It is also important to dispel the myth that morphine is the only option for pain management in hospice care. While morphine is a commonly prescribed opioid due to its effectiveness, there are alternative opioids available, as well as non-opioid pain management strategies. The choice of medication is based on individual patient needs, preferences, and response to treatment.

There may be concerns about morphine's potential side effects, such as constipation, nausea, and sedation. However, healthcare providers work closely with patients to manage these side effects and improve comfort. Various medications, lifestyle modifications, and supportive therapies can be employed to minimize the impact of these side effects on patients' overall well-being.

Misconceptions surrounding the use of morphine in hospice care can be addressed through evidence-based practice, advance care planning, and open discussions to educate. Properly administered morphine does not hasten death. It is important to educate patients, families, and healthcare professionals about the benefits and limitations of morphine, as well as alternative pain management options. By ensuring informed decision-making and providing compassionate care, we can help alleviate unnecessary fears and provide optimal pain relief for patients in hospice care.

Waldo Rios

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