Monday, November 30, 2009

Morphine Derivatives

Welcome to the 4th addition of the Team Opioids blogs. This week's topic will cover the opiate drug, Morphine.

History of Morphine

Morphine was discovered in 1803 in Germany by Freidrich Serturner. Serturner was curious of the medicinal properties of opium and isolated the organic alkaloid compound of morphine from the opium poppy. Morphine was a popular medicine for 18th century physicians for its ability to relieve pain and provide relaxation to those who take it. It was also prescribed as a cure for alcoholism. With its positive factors, "patent medicine" were produced using morphine as an ingredient. Some products were made from more than 50% morphine. During the Civil War, opiates were used as the primary analgesics to treat injured soldiers. Opium, laudanum, paregoric, and morphine salts were used to treat pain and entering of diseases. The significant use of opiates eventually led to morphine addiction, thus the soldiers were known as "opium eaters" or "morphinists". The addiction later led to the restrictive use of opiates.


Use of Morphine

Morphine is commonly used for its analgesic properties in relieving pain. It comes in two forms: liquid and tablet. They can be administered via intramuscular, intravenous, subcutaneous, or oral. Dosage for analgesic effect is approximately 10mg, as compared to 60mg to 80mg in meperidine, a man made morphine. Onset of analgesia occurs within 5-20minutes following intramuscular administration and peak effect at 60 minutes. New epidural morphine can provide up to 48 hours of analgesia with a single injection.

Morphine acts as an agonist at μ-receptors. Perception of pain is altered as it travels to the reward centers, located in the brain and spinal cord. Thus leading to inability to feel pain. Alterations in mood, dysphoria, euphoria, relief from headaches are some of the effects of morphine use.

Morphine sulfate is a white crystalline power (white cubical mass) and is soluble in water.


Dangers of Morphine Addiction

Tolerance level can be built up over sequential use of morphine. As tolerance to morphine is established, the level of analgesic effect between each dosage will decrease thus leading to an increased dosage to achieve the same pain relief as the initial dosage. Withdrawal includes nausea, chills, tremor, diarrhea, etc. Babies born from morphine-using mothers will also go through morphine withdrawal due to crossing of the placental barrier.

Detox from morphine addiction is extremely dangerous. Physical and emotional traumas can cause stroke, heart attack and death. Methadone is used to control the morphine addiction withdrawal but people will typically acquire an addiction for methadone on top of morphine addiction. Thus the best way to get off morphine is to go cold-turkey (stop using the drug without help from other drugs or medications). This ensures no opportunity of having a "mixed addiction", being addicted to a new drug while getting off an old one.

There are cases where morphine is used as a substitute for illicit heroin or as a form of treatment for heroin dependence. The substitute for morphine addiction itself is usually a narcotic with similar analgesic effect, sometimes Demerol.


M and MJ: Morphine and Michael Jackson

In 1997, Michael Jackson released the remix album Blood on the Dance Floor: HIStory in the Mix. Although it is the best selling remix album ever released, this album contains one of the controversial songs in Jackson's career. "Morphine", centralizes on the theme of drug usage of Demorol and morphine. Demorol, generically known as meperidine hydrochloride, is a man-made synthetic compound with similar analgesic effect as morphine. This drug is prescription only and distribution is strictly controlled.

Throughout the song, Jackson made many references to morphine and Demorol in the lyrics. Critics have commented his song to be sung from the perspective of the drug itself. Others say it foreshadows Jackson's ongoing drug addiction. Unfortunately, Michael Jackson passed away on June 25, 2009 after suffering cardiac arrest.



Video of Interest

To further your knowledge of the topics from past weeks, please take the time to watch this educational video, Illegal Drugs and How They Got That Way - Opium, Morphine, & Heroin, from The History Channel.




References

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The 5th and final addition to the Team Opioid blog will be added next week.
Please stay tuned for it.

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