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Morphine

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Morphine is a strong analgesic drug. Apart from that, morphine gives an intense, intoxicating effect. This is why it’s used for both medical and recreational purposes. Morphine is made from opium; the dried sap of the poppy plant. Opium contains a combination of opiates, including morphine. 

Morphine and heroin are closely related, as morphine can be made into heroin. First, morphine is extracted from opium, followed by a chemical reaction that turns it into heroin. Therefore, heroin has a very similar effect to morphine. The main difference is that heroin passes the blood-brain barrier more easily, resulting in it kicking in faster than morphine does.

In the Netherlands, morphine isn’t often used in a recreational context. However, in America, the situation is completely different. In this article, you can read about the history, usage, biochemistry and the risks of recreational use of morphine. We also discuss the mafia-like role that the pharmaceutic industry plays when it comes to illegal distribution of this substance.  

Opium poppies

History of morphine

Opium has been around for a long time. In Baghdad, a clay tablet with cuneiform script dating back to 1300 BC was found. It described the cultivation of the poppy plant. Another description of opium was found in Egypt, dating back to 1500 BC. In Greek mythology, Demeter, goddess of harvest and agriculture, claimed that smoking opium would relieve her sadness. Alexander the Great (356 – 232 BC) was also a great fan of opium. Since time immemorial, opium has both been used as a painkiller, and as a recreational substance.

Laudanum

In 1525, opium entered Europe’s market as an alcoholic extract called Laudanum. It was used as a painkiller and sleeping aid. For a long time, opium abuse wasn’t a widespread problem. This, however, was changed by the East India Company. When they entered China, they found many beautiful products the Dutch and British were really into, such as spices, tea and porcelain. However, the people from China were hardly interested in any goods that came from Europe. As a result of this, a lot of money was spent in China, without any profit. The Dutch and Brits did find a solution for this problem. In the early 19th century, the Europeans started to ship opium to China. As a result of that, in 1830, about 15.000 Chinese people had become addicted to opium.

As a result, The Dutch and British could easily get nice stuff from China for little money. Of course, the Chinese government did not like this, so in 1839, they destroyed their complete stock of opium. The street value of this would now translate to 300 million euro. The British felt offended, and even though they had to come from far away, the Brits won the first opium war using their modern warships. This allowed the Brits to continue making the Chinese population addicted to opium. In 1860, China lost another opium war from Britain. Amongst the Chinese population, opium addiction continued. However, it started to become a more widespread problem.

This problem became worse when in 1803 pharmacist Friedrich Sertürner isolated morphine from opium. Morphine is named after Greek god Morpheus, who is known as the god of dreams.  Although the discovery of morphine, due to its strong analgesic qualities, could be seen as a great break-through in the medical field, it also had a major dark side.

Next to prescribing it as a painkiller, doctors started to prescribe morphine to help treat opium addiction. But of course, this only made it worse, as morphine appeared to be much more addictive than opium itself. Unfortunately, that realization came too late. A great number of opium addicts became even more addicted. In 1878, diacetylmorphine was synthesized from morphine. We now know this substance as heroin. History repeated itself; doctors thought they could treat morphine addiction with this “super-morphine”, which lead to even more severe addiction problems.

Status

In the early 20th century, opiate addiction was considered a worldwide problem. Therefore, in 1912, the Dutch opium law (Opiumwet) was implemented, making it illegal to use opiates recreationally. From this moment on, morphine and heroin could only be used as medication.

Biochemistry

Heroin molecule

In principle, heroin works the same way as morphine does. Heroin, however, contains two more acid groups, allowing it to pass the blood-brain barrier more easily. When it’s in the brain, the acid groups detach, and the substance turns into morphine. The only difference between the two is that heroin reaches the brain faster, and therefore hits harder.

In the brain, morphine attaches to opiate receptors, followed by a very complicated biochemical process resulting in decreasing the release of glutamate and Substance P. These neurotransmitters are needed to experience pain. Lack of these neurotransmitters results in a numbing effect, where one feels less pain. [1]

Apart from that, morphine has the same effect as endorphins. Endorphins make the body produce dopamine, which induces a blissful state of mind. Morphine makes it so that more dopamine is released [2]. Because it attaches in a stronger way than endorphins do, the euphoric feeling lasts longer. 

Morphine moleculeMainly the euphoric effects induce the pain-killing qualities of the medicine. It’s hypothesized that, in principle, the pain is still present, but due to the euphoric effects users don’t focus on their pain, making it more bearable.

Usage

In hospitals, morphine is most often administered through an intravenous drip, although it’s sometimes administered in the form of morphine pills. Morphine plasters are sometimes used, where one’s skin gradually absorbs the morphine.

As a recreational drug, morphine is often vaporized. This is done with a base pipe, or with a piece of tin foil with the morphine on top, heated from below. Through a small tube, the user inhales the vapour. This is called “basing” or “chasing the dragon”. 

Experience

When injected, morphine works very quickly and gives an intensely intoxicating effect. It has shown that not everyone reacts to morphine the same way. This is caused by the fact that not everyone has the same opiate receptors. Gender, medical conditions and medication can affect the way morphine works. For example, some people get really nauseous after taking – medicinal – morphine and hardly experience any intoxication. Others do not get many side effects, allowing them to fully immerse in the blissful state morphine induces.

If you ask people you know about experiences with medical morphine, you might notice that the experiences are divergent. Some people were horrified by the experience, while others loved it. This diversion is caused by a difference in opiate receptors. If the euphoric effect occurs, an overwhelming sense of well-being seems to wash away all feelings of pain, fear, anger and sadness. An intensely dreamy feeling occurs, in which you seem to completely immerse.

Addiction

People who experience these positive effects will, of course, run the highest risk of getting addicted. This addiction entails both mental and physical dependency. Chimpanzees that got the substance administered on a daily basis showed heavy dependency, and eventually preferred morphine over food. This shows how addictive and dangerous this drug is. [4]

Where, in the beginning, a morphine user experiences euphoria when taking the drug, with extended use, the user will find their emotions to be heavily numbed. Someone who is addicted to morphine often has hardly any social contact, and selects people they spend time with primarily by their usefulness.

Physical addiction occurs because using morphine heavily stimulates the opiate receptors. To balance it out, the body breaks down opiate receptors. This process is called “downregulation”. [5] Downregulation explains why an addict needs higher doses for the same effect. If you’re addicted to morphine, you have fewer opiate receptors than people who aren’t. Quitting causes certain biochemical processes to function less adequately, which makes one very ill. This results in the well-known withdrawal symptoms. Fortunately, the body quickly creates new opiate receptors; in three days the withdrawal symptoms are over. 

Illegal market

In Europe, illegal distribution of pharmaceutic opiates isn’t a big problem. This is different in America, where opiate abuse causes almost as many deaths as weapons and traffic accidents. More people die from a painkiller overdose than from heroin.

In America, doctors prescribe painkillers very easily, which contributes to the problem. However, it’s the pharmaceutic industry that promotes it. In 2007, the company Purdue Pharmaceuticals was convicted for downplaying the risks of opiates and purposely misleading doctors about it. On top of that, the company was aware that a major part of their products ended up on the illegal market, through drug dealers and corrupt doctors. The company had to pay a 635 million dollar fine. This might seem like a huge sum of money, but in fact, it was not so much considering the company made 31 billion dollars through these drugs. Therefore, the fine hardly had an effect.

Medical morphine

Medicinal morphine

Morphine is definitely the most effective painkiller used in hospitals. In the past, morphine was used for illnesses that induced a lot of coughing, as morphine surpresses coughing. Today, codeine is used for this purpose. This substance is extracted from opium, it is also possible to extract it from morphine. The intoxicating effect of morphine is lower, while the cough surpressing effect is much higher. The liver converts codeine into morphine. This is why codeine induces a slightly intoxicated state of mind. Not every person is equally capable of converting codeine into morphine, making the intoxicating effects completely dependent on the person. However, codeine can definitely be addictive.

Risks and side effects of morphine

Although we would never want to live in a world without medical morphine, using it is definitely risky. Here’s a list of the most occurring risks and side effects. 

  • It has shown that people who get prescribed medical opiates, have a higher chance of getting into recreational opiate use. Medical users are familiar with the effects, making it easier to take the next step into opiate abuse. It’s a good thing that European doctors prescribe it more sparsely than Americans. There’s only a thin line between medical use and abuse. 
  • There is a chance of developing a tolerance. In some cases of medical use, the user needs to gradually reduce the dose. Recreational users who get addicted will have to kick their habit, which might lead to withdrawal symptoms. 
  • Everyone reacts differently to morphine, making it tricky to find the right dose. This could lead to an overdose. Morphine slows down respiration. When overdosing, one could die from not breathing. 
  • Extensive morphine use causes obstipation. This is why it’s often prescribed in combination with laxatives.
  • Due to the overwhelming intoxicating effect, morphine users are often not interested in sex. This can cause relationship problems. 
  • Furthermore, it can cause muscle cramps. This makes it harder to urinate, and can cause gallstones.
  • Finally, it can make you nauseous, and induce vomiting. If a user passes out after using morphine, and vomits, they can choke in their own vomit.

Morphine for sedation

Morphine can also be used for sedation, so that the patient can painlessly die of natural causes. This procedure, called sedation, is often used on terminally ill cancer patients. Using morphine for euthanasia is uncommon, unlike what many people believe.

Conclusion

In fact, medicinal use and recreational use are closely related. In both cases, the drug is used to escape the painful reality. Fortunately, in the Netherlands, opiate abuse is not a very big problem, which is great, because under the right circumstances, morphine has great benefits. Morphine has taken away a lot of suffering, but has also caused a lot of suffering as it has led to major addiction problems. Morphine can be considered both a gift and a curse.

References

  • Kosten TR, George TP (July 2002). "The neurobiology of opioid dependence: implications for treatment". Science & Practice Perspectives. 1 (1): 13–20.
  • Dopaminergic neurons: Effect of acute and chronic morphine administration on single cell activity and transmitter metabolism, Journal of Neural Transmission, June 1978, Volume 42, Issue 2, pp 99–116
  • Opioid Metabolism, Howard S. Smith, Mayo Clin Proc. 2009 Jul; 84(7): 613–624.
  • Morphine addiction in chimpanzees, 1940, Comparative Psychology Monographs, 15, 7, 132
  • 5. Prefrontal cortex AMPA receptor plasticity is crucial for cue-induced relapse to heroin-seeking Michel C Van den Oever1, Natalia A Goriounova2, Ka Wan Li1, Roel C Van der Schors1, Rob Binnekade3, Anton N M Schoffelmeer3, Huibert D Mansvelder2, August B Smit1, Sabine Spijker1,4 & Taco J De Vries1,3,4


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