INFORMATION ABOUT OPIOIDS
This information answers questions frequently asked by people who express concern when the use of morphine is suggested for their pain. 1. What is morphine? Morphine is a natural product which has been used for centuries as a pain relieving medication. It is recognised around the world as one of the most effective medications to relieve cancer pain, and is also used to treat pain in other conditions. Morphine comes in a wide range of forms and the best form for you should be decided with your own doctor. 2. How does morphine work? Morphine interrupts the pain signals going to the brain, reducing the pain sensation. At the present time in Victoria many hundred people are safely taking Morphine with effective pain relief. Morphine in small doses can also help relieve shortness of breath in people with breathing difficulties. 3. Where should I store morphine? Morphine should be kept in a cool place, away from the reach of children. 4. How should I take morphine? Morphine Mixture (Ordine) There are a number of different strengths of Morphine mixture and therefore the dose prescribed by your doctor needs to be carefully measured in a syringe or medicine measure. It tastes bitter, but you can add a flavouring such as cordial or fruit juice if you choose, and follow with a glass of water. Morphine mixture acts quickly to relieve discomfort, and the effect normally lasts for about four hours. Morphine Tablets or Capsules. (Anamorph or Sevredol) Morphine tablets are available in different strengths and also provide pain relief for about four hours, but most people find Morphine mixture is more convenient to use. Long-acting capsules (Kapanol®) These may be swallowed whole or opened and the granules sprinkled on a little food, such as ice cream, yoghurt or apple puree. The small pellets must not be chewed or crushed. Kapanol may be taken every 12 hours or every 24 hours by the clock and your doctor will discuss with you which is most appropriate for your particular needs. Long-acting tablets (MS Contin®) MS Contin® must be swallowed whole and never chewed or crushed. MS Contin® is usually taken every 12 hours.
The Sisters of the Little Company of Mary 476 Kooyong Road, Caulfield, Victoria 3162 Australia Tel: 03 9596 2853 Fax: 03 9596 3576 www.bethlehem.org.au
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INFORMATION ABOUT OPIOIDS Cont…
Morphine Injections Morphine injections do not provide better pain relief than morphine by mouth, but are needed when tablets or mixture cannot be taken. Injections are normally given by a nurse or doctor, but it may be possible for a family member to be trained to give them as required. These are normally given through a butterfly needle which the nurse can leave in place under your skin. A small automatic syringe driver is sometimes used to inject morphine continuously. These are placed in a small carry bag which may be pinned under your clothing or strapped to your body. The syringe driver will be refilled regularly by a nurse or doctor, usually every 24 hours. 5. What will I do if the pain comes back? Your doctor or palliative care nurse will explain what to do if your pain returns or you get episodes, or breakthroughs, of pain while taking regular Morphine tablets or mixture. You may be advised by your doctor to take additional doses of morphine mixture as well as your regular morphine until the pain is controlled again. It is important that you do not change, or miss, your regular dose of morphine without you or your palliative care nurse discussing it with your doctor. The dose of regular Morphine may then be adjusted if considered necessary. 6. Can I take other medication whilst taking morphine? Morphine is usually safe taken with commonly used medications. However, you should tell your doctor about any other treatments you are having, including over the counter medications, to ensure that these are appropriate. 7. Will I need more morphine over time? The experience of pain is different for each individual. People often remain on the same dose of morphine for long periods of time. Others find that their morphine dose needs to be adjusted on a regular basis to control their symptoms. If your morphine dose needs to be increased it does not always mean that your disease is worse. 8. Will I become addicted to morphine? No, when the appropriate dose of morphine is used for pain relief addiction does not occur. 9. Will morphine make me drowsy? Some people feel drowsy when they first begin to take morphine or if the dose is increased. This usually settles after a few days you will return to being as alert as usual. If drowsiness lasts more than a few days, discuss it with your doctor.
The Sisters of the Little Company of Mary 476 Kooyong Road, Caulfield, Victoria 3162 Australia Tel: 03 9596 2853 Fax: 03 9596 3576 www.bethlehem.org.au
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INFORMATION ABOUT OPIOIDS Cont…
10. Will morphine make me feel nauseated? Most people do not experience nausea when they take Morphine. Nausea may occur when Morphine is first started, but it usually settles by itself in a few days. If nausea lasts longer there is effective medication to control it, so discuss it with your doctor. 11. Will morphine make me constipated? In many people Morphine causes constipation which will require a laxative to control. You should continue taking a laxative as long as you are taking morphine. If your bowels cause continuing problems, discuss this with your doctor, palliative care nurse or pharmacist. 12. Will I become confused when I take morphine? Occasionally people become confused or suffer from vivid dreams while taking morphine. This occurs more often when Morphine is first commenced or the dose changed, but usually wears off within a few days. However if any problems persist, please discuss it with your doctor or palliative care nurse. 13. Isn’t morphine only given as a last resort? No. Many people live for years taking morphine. Morphine will not shorten your life expectancy when used appropriately to control pain. The aim of morphine treatment is to improve your comfort and so enhance your quality of life, enabling you to do the things which are not possible if pain is unrelieved. 14. Can I drive if I’m taking morphine? There is no simple answer to this question. Every one of us has a personal responsibility to drive only when not affected by medications, alcohol or illness. Morphine may cause drowsiness or reduce your mental alertness and concentration, particularly when first commenced or after an increase in dose. If you feel you are affected by Morphine you should not drive your car. This problem usually wears off quickly and you can return to driving your car, but if you have any concerns about this, please discuss it with your doctor. If you have any other questions about morphine, professional staff of any palliative care service or your local doctor will be happy to provide additional advice.
The Sisters of the Little Company of Mary 476 Kooyong Road, Caulfield, Victoria 3162 Australia Tel: 03 9596 2853 Fax: 03 9596 3576 www.bethlehem.org.au
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