Morphine Overdose – Amount, Symptoms, Treatment

Morphine Overdose

Morphine is considered the most abundant alkaloid in opium. Opium is a dried sap derived from the seedpods of opium plant. In medicine, morphine is considered the benchmark or gold standard for the use of analgesics in order to relieve severe forms of pain. Morphine is centrally acting along with other opioid or narcotic analgesics. Being centrally acting, there is rapid onset of effects. Morphine has a very high potential for tolerance, which increases the risk for physical and psychological dependency and morphine addiction.

The primary use of morphine is to treat severe acute and chronic pain. It is usually used for pains related to labor and myocardial infarction because other analgesics may be deemed ineffective to relive these severe types of pain. Morphine may also be used for the relief of shortness of breath for cancer patients. Morphine is administered through intravenous, intramuscular and subcutaneous routes. Because of potential dependence to morphine, patients may have increased dosage in order to yield desired results, which may potentially lead to morphine overdose.

Morphine overdose is especially dangerous because of increased side-effects than other narcotic analgesics. Morphine is not given to patients with respiratory depression because of additional respiratory compromise. People with depressed respiratory system include people with:


  • Upper airway obstruction
  • Severe obesity
  • Phrenic nerve paralysis
  • Kyphoscoliosis
  • Chest wounds
  • Emphysema
  • COPD
  • Asthma

Morphine overdose is considered fatal because of affectation of the respiratory center of the brain. Morphine binds with other opiate receptors in the body that is found in most organs in the body, leading to variousmorphine overdose symptoms. Patients with morphine overdose should receive emergency medical treatment because of possible death.

Overdose Amount of Morphine

The lethal dose of morphine is 200 mg. In cases of hypersensitivity reactions to morphine 60 mg of morphine may already precipitate death. People with addiction to morphine can usually tolerate 3 grams of morphine  a day.

The duration of morphine effects is about 3 to 4 hours via subcutaneous and intravenous routes and 3 to 6 hours via the intramuscular route so these times are the most crucial for treatment of morphine overdose. In order not to intensify morphine side-effects and possible morphine overdose, the drug should not be used along with sedatives, antihistamines, alcohol, anesthetics, phenothiazines, tranquilizers, hypnotics and other narcotic and psychotropic drugs. Use with amitriptyline may also lead to amitriptyline overdose.

Symptoms and Signs of Morphine Overdose

Symptoms of morphine overdose may result from the binding of morphine in all possible opiate receptors in the body. Morphine overdose symptoms include:

1. Respiratory depression

This is the most life-threatening morphine overdose symptom because of depressing the respiratory enter of the brain leading to respiratory collapse. Health care providers should monitor for decreased respiratory rate of less than 12 breaths per minute because this may signal respiratory failure.

2. Pinpoint pupils

The pupils may appear constricted and the size of a pinpoint.  Patients under morphine therapy should be monitored for papillary reactions.

3. Severe constipation

The binding of morphine to opiate receptors in the intestines slows down the peristaltic activity leading to constipation.

4. Nausea and Vomiting

Patients may also suffer from vomiting because of slowed gastric emptying time.

5. Hypotension

Morphine overdose leads to vasodilatation causing severe hypotension.

6. Weak and Thready Pulse

The decreased blood pressure results in weak and thready pulse to compensate with the decreased blood flow to the organs.


7. Decreased level of consciousness

CNS depression may bring about drowsiness, lethargy, stupor and eventually coma when managements are not instituted.

8. Muscle weakness

The skeletal muscles are also affected leading to flaccidity. Weakness of respiratory muscles especially the diaphragm usually intensifies respiratory depression.

9. Seizures

The patient may also suffer from seizure due to affectation of the nerve impulse transmission in the brain.

10. Cyanosis

Cyanosis is a sign of respiratory collapse because of poor oxygenation of the blood leading to bluish discoloration of the skin and mucous membranes.

The presence of triad symptoms such as pinpoint pupils, coma and respiratory depression is a sign of morphine toxicity.

Long term effects of Morphine Overdose

The long term effects of morphine overdose may include:

Causes and Risk Factors of Morphine Overdose

Causes of morphine overdose include accidental intake of high amounts of morphine. Other people may also be at risk for morphine overdose because of individual requirements for the drug. Risk factors include:

  • Being a pediatric patient
  • Geriatric patients
  • Patients with hypersensitivity to morphine
  • Drug addicts or those who develop drug dependence

People who developed drug dependence to morphine are especially at risk because they tend to tolerate the effects of the drugs and require larger dose of morphine, which may lead to morphine overdose.

Diagnosis of Morphine Overdose

The diagnosis of morphine overdose depends on the symptoms of the patient as well as presence of history of morphine use. Blood levels of the narcotic usually ascertain the diagnosis of morphine overdose.

Treatment of Morphine Overdose

Morphine Overdose pic

Morphine overdose requires emergency measures to reverse the effects of morphine overdose in the body. Treatments for morphine overdose include:

1. Use of activated charcoal

Those who have ingested large amounts of morphine may require activated charcoal to remove the drug in the stomach to prevent absorption in the intestines.

2. Intravenous fluids

Intravenous fluids may also be needed to prevent dehydration and for access of the circulation for medications.

3. Administration of laxatives

Laxatives may also be given to remove the morphine in the gut and also to reverse constipation.

4. Administration of naloxone

Naloxone (Narcan) is the antidote for morphine toxicity. This drug competes with morphine in the receptor sites, thereby preventing the binding of morphine in the opiate receptors in the body. Naloxone also has the potential of replacing morphine that have already attached to the receptor sites; thereby reversing the effects of morphine overdose.

Rapid managements should be instituted to prevent death in patients who have experienced morphine overdose.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/002502.htm

http://en.wikipedia.org/wiki/Morphine

http://www.drugs.com/morphine.html

21 thoughts on “Morphine Overdose – Amount, Symptoms, Treatment

  • 13/06/2013 at 9:29 pm
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    i recently took a morphine overdose family was called and i was given 2 days to live all i remember is PAIN please dont even think of this the medics were brilliant and i survived it would have been a cruel death

    Reply
  • 28/01/2014 at 8:17 am
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    I usually take 60mg. Every 8 hours. And additional 30 for break thru Pain.
    tonight tho I haven’t been able to stop the pain and took about 90 mg extra.
    I am afraid that I have harmed myself. So far the pain is still very bad. Can you tell me what to do? i
    don’t want to die, just get away from the pain

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  • 01/03/2014 at 4:06 am
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    i also deliberatly overdosed on morphine all i remember is pain dont think of doing this if i was on my own i would not be writing this

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  • 20/03/2014 at 5:38 am
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    Why would you not be “doing this” or “writing this” if you were on your own.?
    Are there persons around you who you wish were not there?

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    • 18/07/2016 at 2:37 pm
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      you are awful to be saying that, have you ever been in pain, it depresses you and you are at a loss you are horrid!

      Reply
  • 03/08/2014 at 1:38 am
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    Donna check your heart for a pulse, was your blood particularly cold when u posted that response to Anonymous? Loneliness kills especially combined with unremitting pain. Shame on you Donna.

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  • 01/12/2014 at 12:33 am
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    i am prescribed morphine and ive been researching overdose in case i need an escape plan. But is sounds scary. I have heard of hospice patients who were overdosed by so called angels of mercy and they seemed to just float unto the next phase as if it were humane. Im confused. Most people in hospice get the drug through the vein. Could this be the difference? That maybe most OD’ers take pills vs vein? im tired of pain, i wouldnt want to put myself in more!

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  • 23/12/2014 at 8:48 pm
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    My boyfriend was given morphine by his PCP at the hospital and they killed him. Instead of letting die a natural death the took God power gave morphine thru IV . They are killers, but the doctor said we will give him morphine and let him die naturally which is false , deceptive and misleading – it a straight up lie. Since he had medi- cal and was suffering from liver damage they just gave up on him. Since I was the girlfriend I had no say in the decision making but the bio mother did and agree with the doctor . This was so wrong cutting his life so short or am I the self self one who wanted him to die naturally and not forced by morphine. Mom thought he was suffering but I was not sure. I didn’t think hospital can kill a patient just cause the family wants them to to stop the suffering. I will have to live this this guilt for the rest of my life. What could have I done differently? I am strongly thinking of writing to the medical board .

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    • 20/01/2015 at 5:37 pm
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      Maybe you should start by taking English classes at your local community college Judy.

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    • 01/08/2015 at 2:36 am
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      Judy,
      Would you rather of had him suffer and in pain? Dying slowly is very painful for both the patient and the family. I had to see my partner die slowly day by day as they first cut off his toes, then his legs, then one arm, then another until he was left with just a torso and a head. All because his family did not want some doctor to play GOD…Listen, you are playing GOD by putting him in the hospital in the first place. If he was left at home and not taken to the hospital he would have died a natural death at home. SO by you insisting he be kept in pain and alive you were as much playing God as they were. SO stop beating yourself up about it. God wanted him home, and granted his mother the strength to let him go. Do you actually think it was easy for her to make that choice? You were the girlfriend, you knew him what, years or so? His mother knew him from birth and I think it is rather cruel to her that you are accusing her is your own naïve way of murdering her own child. What you could have done differently is treated him better while he was alive and then maybe you would not have had the guilt when he died. AND an event that should have brought the two women together in his life, actually drove a wedge between them, very sad.

      Reply
  • 18/02/2015 at 9:40 pm
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    I take SR 30’s 2 times a day presently. I was on 4x day SR60’s for injuries I incurred in Iraq. The VA pulled my morphine and put me on a taper when they found out I was double dipping. I was using morphine and THC in conjunction with the occasional beer. I learned very quickly what it was to build tolerance, then lose the tolerance my body had developed to it. If I added a a vicodin.. supplied by another vet.. the pain was manageable. I guess my point is, if you have a tolerance built up you need to be very careful if the dose is changed.. so not to go back to the 60’s when you are tapered to 15’s then zero. You are not supposed to take more than the doseage supplied..period. BUT..if you happen to find yourself in a spot, as with me id double dip the 60’s when my pain was so bad I was literally immobile, often times I would forget I dosed, then I’d take another one.. discovering when I got nauseated it was too much. I want to say nausea would be the first symptom, it is your body rejecting the medicine.. ie..too much. If you get sweaty, clammy, terribly sleepy or slumpy..changes in complexion, pail or blue you need to get concerned very quickly. Activated carbon and IV fluids are the key but only work if the pills are in your stomach still, unless they really go nuts on you and give you the colon filler version. Often with the SR30/60/90/120’s time between doses is very important. Your body will tell you pretty fast if you are in trouble. They are put together in a “wax” based binder that only lets it come out at a known rate so they are safe at the dose your doctor has prescribed. If you have a tolerance building then it may be time to increase your dose. I started with Vicodin 10mg, then 15’s and Vicodin, then SR30’s then SR60’s at my highest dose. This is currently running it’s course for me, I have been taking Morphine and THC now as prescribed. My dose is actually 2 SR30mg and as much pot as I can legally grow.. I am in WA state. I might suggest for you to back off the dose starting by as much as half and coupling it with a high CBD/CBN low thc strain of pot in edibles. It will work, I promise. Unless your pain is so severe that it is crippling.. which I have experienced. In which case you can increase your thc dose accordingly. I get a pleasant calm, without the severity of the pain. The edibles are especially helpful at night. I take my doses at 8 and 8 and eat maybe 250-500 mg of THC edibles. These are measured by my own process of local lab testing my plants for their effective properties. I avoid High THC levels so as not to get any sort of psychedelic or adverse funny feelings. Unless I want to then I just use a different type of flower. There is much to be said about this type of personal research. When I was on my last nerve literally with bureaucracy and met with the conflict of THC.. Now the VA will not accept its use for most, it is case by case, by your dr’s orders, monitoring and all the good things like pill counts. I am pleased to say I helped pave the way for a lot of vets in my state by challenging so to speak the system. Having your dr on board helps too. She was reluctant, and is still a little hesitant.. but the proof is in the pills. The THC has gotten my off my blood pressure meds, morphine will do this, THC will work synergistically and does react different with people so it is good to have the monitoring. Rarely you might see a reaction due to hyper sensitivity or allergy to the weed, which is a bummer because the risks out weigh the bene’s and will make you a risky candidate. I write this to tell you there is real benefit from the weed. Get that dose reduced soon because it will only get worse. That is the nature of the drug. Both are extremes, but the pain you are dealing with is extreme and can be controlled with a lower dose of the medicine.. which can reduce the risk of OD’ing on large doses. 200mg start worrying.. 300, unless you have been taking high doses can and will likely end you up in the er.

    Reply
  • 28/02/2015 at 3:33 am
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    Kyle what sort of gite are you to make such a callous comment to someone in so much pain you should be ashamed of yourself.

    Reply
  • 05/03/2015 at 9:39 am
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    I truly believe that my Wife, April was murdered at Desert Springs, Las Vegas, Nevada!!! Her male hindu Doctor?? was worried about a possible malpractice suite….Dr. Rajeet Sood!!!!! Iwas to stupid to believe that they were killing my Wife—–right in front of me….The Clark county Medical Examiner,,,Dr. Sood and Desert Springs Hospital fought me regarding an Autopsy—-“none needed”???April had no heart problems…possible kidney problem……Dr. Sood didn’t get a malpractice suit—–and I lost my Wife.Charles F. Carpenter..3/5/2015

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  • 05/03/2015 at 9:45 am
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    I hope Dr? Sood reads this…The guy is both crazy and dangerous……or,,is morphine poisoning the new—almost un detectable method of preventing……………. Malpractice suits in Nevada???Any half assed Accountant could prevent ,,,,clean up an audit trail.////////

    Reply
  • 09/07/2015 at 5:14 am
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    Hi,

    Exactly a week ago today I made the mistake of ingesting four 15-milligram MS-Contin pills, then crushing and sniffing two more about 15 minutes later. I had never taken Morphine before, and had not used any opiates for about 6 weeks, but have a long history of addiction.

    I felt pretty good for about 3-4 hours, then began to feel increasingly nauseous, eventually vomiting once about 8-9 hours into the ordeal. I then fell asleep for approx. two hours, waking up feeling stable and ok.

    I will NEVER repeat this experience, since it was mostly unpleasant and nauseating. However, for the last 7 days, I have been obsessing that I might have OD’d and caused some kind of permanent brain damage.

    Is this possible?

    Thanks in advance for any response.

    Reply
  • 06/12/2015 at 8:50 am
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    A very good friend found me unresponsive in my kitchen floor. While on the phone with 911 operator she asked him about my breathing, I was breathing 5 breaths a minute. He had to start chest compressions. I had been prescribed morophene 60mg 2 times a day for about a year, it hat built up in my system and obviously caused me to pass out. I remember nothing about the whole situation. I was found at about 6:00am on a Monday and didn’t wake up enough to remember anything till Tuesday afternoon. I WILL be changing my pain meds ASAP! I owe my life to my best friend Rick, so THANK YOU!!

    Reply
  • 08/12/2015 at 3:27 am
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    On 5th April 2015 I took an overdose of 58 tablets of 10mg morphine. So in general I had 3 times the lethal dose in my body; plus alcohol and codeine. When I was admitted into hospital, I was critically ill with respiratory failure and very weak pulse; my heart rate was 4 beats per minute. I kept drifting in and out of consciousness; it was the most scary experience of my life…Honestly, if anyone is suicidal this is the worst way to go.

    I remember jolting out of my overdose sleep using naloxone. I believe they injected it about 6-7 times. What strikes to amaze me is the fact that I took the overdose around 2:00pm, and the effects only kicked in at 11:00pm.

    Nonetheless, I consider myself lucky, as I am only 16 years old.

    Reply
  • 28/01/2016 at 12:20 am
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    I just had an experience that I don’t know what to think about it. I fell 4 nights ago, tripped over some dog beds and igloo’s landing on bricks and breaking my wrist and elbow. Went to ER, got X-rays which cause even more excruciating pain because they had to straighten my arm. Sat there in excruciating pain for 3 hours before the nurse came in with a huge shot. He commented several times he was giving me an extra large dose and gave it in the arm that was broken. Within a few minutes I started feeling woozy and it just kept getting stronger. I got weak, sweat started pouring off of me, I couldn’t breath. I could feel my heart jumping beats every few beats. I couldn’t open my eyes and couldn’t hardly talk. Started seeing things like flying over orange dunes and other things. I started breathing so slow my friend kept telling me to breath. The nurse came in and said she isn’t taking this very well and said I couldn’t go home yet. I was soaked from sweat. I heard the nurse say she is getting some color back so they put me in a wheelchair and pushed me out the back door and into the car without any discharge papers or follow up instructions which I thought was kinda strange. I vomited all the way home and for the next two days. 36 hours I was a mess from that morphine shot. They didn’t cast my arm, said they don’t do that anymore and put me in a sling. I couldn’t even sit up I was so weak, couldn’t open my eyes, my head kept going from side to side. Someone at home had to stay up all night with me telling me to breath. Is that a normal morphine effect?

    Reply

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