Morphine Withdrawal Timeline and Symptoms
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Morphine is an opiate pain medication and it belongs to a class of drugs called opioid pain relievers. An opioid is also sometimes referred to as a narcotic.
Morphine is used to treat moderate to severe pain. Extended release morphine capsules are used when around the clock pain relief is required. It is prescribed as a painkiller and it is highly addictive.
Even when used appropriately, a patient can become addicted in as little as 2 weeks.
Addiction to this drug can quickly get out of control as over half of the drug-related deaths in the US are caused by morphine and heroin overdose. Because it is a depressant, the withdrawal symptoms can be excruciating. It is highly recommended that an addict goes through a substance medical detox where the withdrawal symptoms can be minimized in a safe place under the supervision of a medical doctor or other qualified healthcare professionals. These kinds of detox programs have been known to be safer, faster and more comfortable.
Morphine Withdrawal Symptoms
After a person stops taking morphine, they are going to have physical and emotional withdrawal symptoms that are all part of the process of detoxification. These symptoms are essentially manifestations of a brain and body adjusting to life without the medication. The physical symptoms can include nausea, vomiting, diarrhea, joint pain, insomnia, sweating, and flu-like symptoms.
The emotional or psychological symptoms are under appreciated but they are no less intense. They can come in the form of anxiety, dysphoria, irritability and a general inability to enjoy life. It is important to note that as morphine is an opiate, over time the body becomes accustomed to the effects of the drug and when absent the withdrawal symptoms will occur. This is the case even for people who use the drug legitimately, although the symptoms might not manifest as acutely as it will with chronic abusers. Withdrawal is a normal, predictable, physical and emotional response of the body to stopping the medication, but it can be extremely unpleasant and sometimes gets so uncomfortable that people go back to taking the drug just to relieve the withdrawal symptoms.
What to expect the first days of withdrawal
When an individual decides to go through with detox, they are going to experience the withdrawal symptoms as the body tries to adapt to this new circumstance. The morphine one has been taking has actually disrupted the balance of the brain chemistry and the body thus craves it when one takes it away. These chemicals in the brain are depleted and one will become agitated.
An individual will experience irritability, skin crawls and feel like they have the flu a hundred times over. The person will also experience watery eyes, body aches and could develop a fever. You just end up being extremely uncomfortable and depressed. This is basically the overview of everything one will go through in the course of withdrawal.
When does it get better?
Depending on how long one has been using and how much, the general rule is that one starts to feel a little better after day 5. At this point, a person will have experienced so much of the physical withdrawal symptoms and they will start to subside a little. The symptoms are still there but they won’t be as severe as they once were. At this point, however, one might find that they’re not getting any sleep and they are about to breakdown but an individual will eventually overcome this if they stay strong. After this stage, one starts to feel somewhat better physically and psychologically and the motivation levels go up. As the brain tries to stabilize the already existing chemical imbalance a patient will feel oneself getting better and better as the days go on. However, don’t get discouraged when it feels like they’re relapsing as this is normal.
The withdrawal from morphine can be broken down into three phases each with its own specific characteristics.
This is the phase right after an individual comes off the drug say about 12 to 30 hours after the last use and one can experience any of the following symptoms; depression, nausea, cramps, diarrhea, insomnia. At this point, the body is basically reacting to the immediate absence of the drug it has become used to. It is the physical phase where one will go through most of the physical pain. However, this is not necessarily the hardest phase. This phase will last about 5 days to a week. An individual comes out of it feeling a little bit better once one gets to phase two.
At this point, the body is going to start working out most of the toxins that one has built up over the time period of the usage or abuse as the case may be. The less time one has been on the drug and the less quantity they have consumed, the easier this stage is going to be. It’s easier for the body to get rid of the chemicals and for the brain to reset to normal. This is the phase where it becomes very important to start supplementing and start taking vitamins and changing the diet and things like that. Phase two will last for about two weeks. As the body works to get rid of all the toxins, it also works to balance the endorphin levels that were depleted during the opiate addiction. Endorphins are depleted because as tolerance and dosage increases, the body ceases to produce its own natural endorphins. Symptoms that might be experienced at this phase include chills, sweating, goose bumps, dilated pupils, leg cramps, and restless leg syndrome.
This is a tough phase and this is where a lot of people run into problems. The symptoms here can be more psychological than physical but there will still be some physical pain and discomfort. Symptoms here include anxiety, restlessness, and insomnia. At this stage a person has to be very careful because having gone through phase one and two, the urge to use becomes stronger than ever at this point and one risks losing all the progress one has made. This stage is critical as it determines whether or not they are going to completely withdraw/detox from morphine.
Alleviating Morphine Withdrawal
Morphine withdrawal can be managed through the use of some drugs and medicines that help in reducing the morphine withdrawal effects. Some of these drugs and their mode of operation include:
- Methadone: This drug works in almost the same way as morphine and produces similar effects albeit considerably lower in intensity. It is, however, much easier to kick than morphine is and the idea is to gradually reduce the dosage over a long period of time until the user can easily make the switch to cold turkey. Some people stay on methadone medication for many months before finally giving it up. It remains the most common withdrawal drug.
- Buprenorphine: This drug works faster and can help detoxification from morphine much faster than methadone but it is also suitable for long-term use. It can be used with Naloxone without any problems.
- Clonidine: This drug instead of relieving the cravings of morphine, helps to reduce the physical manifestations from the morphine withdrawal. Physical effects like aggressiveness, sweating, muscle aches and flu-like symptoms. It can be effective because it’s these physical symptoms that make morphine withdrawal very difficult.
- Naltrexone: For people who fail their detoxification process at the third stage will benefit from this drug. It is meant to assist people from relapsing and giving in to the drug’s pull.
There are other alternative methods such as joining support groups, yoga, and exercise, that can be effective in relieving the symptoms from the withdrawal from morphine. At the very least, they provide a morale boost to help stay the course and not falter from the goal of kicking morphine addiction for good.
The withdrawal symptoms of morphine involve physical and emotional changes. It will take anywhere from 2 to 3 weeks or the physical symptoms to completely disappear and 1 to 3 months for the emotional and psychological symptoms to do the same. The duration depends primarily on how long an individual has been using and at what levels. Most people continue to use because they are so scared of going through withdrawal. But with the right attitude and healthier habits, it becomes easier to live without morphine and one eventually won’t need it anymore.
Morphine addiction and withdrawal is a major issue because it affects so many people who aren’t necessarily trying to abuse the drug to start with. We have seen veterans who are suffering from posttraumatic stress disorders turn to morphine to help them get through their pains and flashbacks. Teens often out of curiosity also experiment with the drug and the body rapidly develops tolerance and they find themselves seeking more and more. Even medical professionals aren’t exempt from this addiction as they already have the access and they turn to the drug to help them deal with the stress and pressures of their demanding jobs.
- Motaghinejad M., Motevalian M., Asadi-Ghalehni M., Motaghinejad O. Attenuation of morphine withdrawal signs, blood cortisol and glucose level with forced exercise in comparison with clonidine. Advanced Biomedical Research. 2014; 3:171. doi:10.4103/2277-9175.139181. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166059/.
- Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization; 2009. 4, Withdrawal Management. https://www.ncbi.nlm.nih.gov/books/NBK310652/
- Mohammad A., Ruhollah M., Mohammad E. R. & Ali S. Effect of Morphine Withdrawal Syndrome on Cerebral Ischemia Outcome in Rats. Iranian Journal of Basic Medical Sciences. 2010; 14(1): 1-8. http://ijbms.mums.ac.ir/article_4945_5af6302caa4413c66fc710ad72e8414b.pdf.
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