Morphine Withdrawal Timeline & Detox

Content Overview

Breaking free from morphine is a complicated process that carries with it the risk of unpleasant symptoms. It may be necessary for you to withdraw gradually or with the help of a replacement opioid drug that will help to lessen the severity of symptoms or prevent others from occurring. Morphine detox is safest when it takes place in a dedicated facility where medical staff can monitor progress.

An addiction to morphine is destructive on many levels. You probably also know that overcoming morphine addiction will require, at some point, undergoing detox and experiencing the withdrawal that comes with it. Detox and withdrawal are necessary components of conquering addiction.

It has been our experience that some of the anxiety of morphine detox can be alleviated if patients know what they are getting into before they start. That is the intent behind this guide. It contains a lot of helpful information explaining what you can expect from morphine detox and withdrawal. Please understand that this information is general in nature. Patients respond differently to detox and withdrawal, so it is impossible for us to say that our information applies to everyone.

Morphine Withdrawal

Morphine withdrawal occurs as a result of the body being exposed to lower amounts of the drug over time. Withdrawal is a natural reaction whenever someone addicted to certain substances begins reducing the amount they use. The severity of withdrawal symptoms in any given case depends on a number of factors including the substances being used, the length of time the person has been addicted, the person’s age, general health, etc.

You should know up front that morphine withdrawal can be a very uncomfortable experience. The longer you have been addicted, the more uncomfortable withdrawal is likely to be. But if you go through detox at one of our treatment facilities, clinical and support staff will do everything they can to make you as comfortable as possible. You will also be medically monitored and assisted.

Morphine Withdrawal Symptoms

Morphine withdrawal symptoms can last anywhere from 72 hours to upwards of 7-10 days. Symptoms can include nausea and vomiting, muscle cramps, agitation and anxiety, depression, stomach cramps and diarrhoea, and drug cravings. If you are addicted to morphine, you may not experience all the withdrawal symptoms; instead, you may exhibit just a few of them.

Causes of Morphine Withdrawal

Morphine is an opiate that affects the brain in multiple ways. Its most powerful mechanism is one of binding and activating opioid receptors in the brain. This action slows down the transmission of brain signals and works to either depress or block the perception of pain. A secondary mechanism is one of encouraging the production of endorphins that further activate opioid receptors in the spinal column. Excess dopamine production is a result of these two mechanisms.

With every successive use of morphine, the brain is trying to compensate for the suddenly imbalanced chemicals. A person who is addicted to the drug has reached a place where the brain is depending on a steady stream of morphine to continue functioning. The brain simply has become used to having morphine in the system. Take that morphine away and the brain is attempting to overcompensate for a chemical that is no longer available in the same volume. This is what causes withdrawal.

When the level of morphine in the system is reduced, the body must once again adjust to this new paradigm. Brain chemicals remain out of balance during the adjustment process, which is what causes many of the withdrawal symptoms. The longer a person uses morphine, the longer the adjustment takes and the more severe the body’s reaction.

A good way to understand morphine withdrawal is to compare it to letting the air out of an inflatable bed. If you simply remove the plug and let the air escape naturally, the mattress eventually flattens out. But it takes a while. The mattress material slowly adjusts to the loss of air pressure. The more air in the mattress at the start of the deflation process, the longer it takes.

Treatment for Morphine Withdrawal

Our rehab clinics utilise a medically supervised and assisted treatment for morphine withdrawal. Medical supervision is necessary to guarantee patient safety throughout. Medical assistance is rendered to make the withdrawal process as easy and tolerable as possible. Clinic staff use every tool available to them, including prescription medications designed to facilitate gradual withdrawal.

Does Morphine Withdrawal Work?

If you are like many of the people we work with, you wonder whether morphine withdrawal works or not. The answer to that question depends on how you define ‘works’. In terms of its medically intended purpose, it absolutely does work. Remember that the purpose of withdrawal is to cleanse the body of drugs. That is exactly what happens during the withdrawal process.

The human body is an amazing machine with a tremendous amount of resilience. Introduce a foreign substance to the body – like morphine, for example – and it will do everything it can to counteract that foreign substance. This is part of the survival mode built into all living organisms. Addiction works against the body’s natural responses by continuing to feed foreign substances into the system. But stop feeding the body and it will eventually cleanse itself.

If you define ‘works’ as successfully and permanently stopping morphine use, withdrawal alone is not likely to work. Morphine is a powerful enough drug that becoming addicted to it has profound physical and psychological consequences. The latter makes it extremely difficult to fully overcome morphine addiction through withdrawal alone.

Morphine withdrawal also might not work to help a person maintain permanent abstinence on the first try. Some people have to undergo detox, withdrawal, and rehab therapy multiple times before they finally conquer addiction. The point to understand is this: though morphine withdrawal is a necessary part of beating addiction, it is not a silver bullet that will lead to being cured on its own. Withdrawal is one part of a lengthy process requiring a significant investment of time and effort.

Medications for Morphine Withdrawal

Medical science has come a long way in the treatment of morphine addiction. Modern treatments include the use of certain prescription medicines that facilitate a gradual withdrawal and help doctors better manage withdrawal symptoms. Below is a list of the most commonly used medications.

Methadone – Methadone is an opioid that has proved helpful for facilitating opioid withdrawal. It may be used in a morphine withdrawal scenario as a way of stabilising the patient before beginning to gradually reduce the amount of the drug being used. Methadone’s effects tend to last longer for people who are long-term morphine users, meaning lower doses can be administered during withdrawal.

Buprenorphine – This is another opioid often used to stabilise the patient. It is normally administered only after withdrawal symptoms begin. Some doctors may rotate between methadone and buprenorphine so as to not take the risk of the patient becoming dependent on either one.

Lofexidine – This drug is a non-opioid alpha-adrenergic agonist that helps ease withdrawal symptoms by initiating an opposite chemical reaction in the brain. This drug is normally not used alongside methadone or buprenorphine. Rather, it is a replacement drug recommended for people whose dependence is either mild or uncertain. The advantage of choosing it over the other two is faster withdrawal.

Dihydrocodeine – This medication is a semi-synthetic opioid analgesic normally used to treat mild to moderate pain. It is slowly gaining acceptance as yet another alternative for stabilising patients during morphine withdrawal.

Other medications are utilised to manage withdrawal symptoms. Some examples include:

  • Loperamide (for controlling diarrhoea)
  • Metoclopramide, prochlorperazine (nausea, vomiting, stomach cramps)
  • Mebeverine (stomach cramps)
  • Diazepam, zopiclone (agitation, anxiety, insomnia)
  • Paracetamol (muscle pain and headache).

Lastly, a drug known as naltrexone is often used in the days and weeks following successful withdrawal to prevent relapse. Naltrexone is an opioid antagonist that prevents the user from experiencing the normal effects of opioids. So if you were on this drug, you would feel no effect from taking morphine.

The one downside of naltrexone is that it can gradually lose its effectiveness if the user chooses to persistently continue using morphine while taking it. Combining the two drugs together eventually creates a scenario in which naltrexone and other opioid antagonists are completely ineffective.

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Morphine Withdrawal Psychosis

Withdrawal-induced psychosis is a common condition that occurs during detox. However, morphine withdrawal psychosis is different from the psychosis induced by other kinds of drugs. Doctors and nurses with experience in treating morphine addicts know how to spot the signs of morphine withdrawal psychosis and treat it properly.

For the purposes of definition, psychosis is a medical condition that “causes people to perceive or interpret things differently from those around them,” according to the NHS. Psychosis can demonstrate hallucinations or delusions, but this is rare in the case of morphine withdrawal. This is what makes the psychosis associated with morphine withdrawal so different.

Where methamphetamine withdrawal psychosis may produce vivid auditory and tactile hallucinations, for example, those same hallucinations almost never occur during morphine withdrawal. Instead, morphine withdrawal psychosis is brought on by mental instability and severe anxiety. The person withdrawing is so overwhelmed by negative emotions that he or she loses touch with reality.

Morphine withdrawal psychosis is similar to psychosis induced by other drugs in terms of the thoughts and actions it produces. The person experiencing morphine withdrawal psychosis will often demonstrate the following:

Anxiety

A person going through morphine withdrawal will be extremely worried and nervous about what he or she is going through. Anxiety tends to be disproportionate to the patient's actual experience.

Desperation

Feelings of desperation may set in as withdrawal progresses. The patient may be extremely desperate to bring withdrawal to a close just to stop the symptoms.

Hopelessness

Patients suffering from morphine withdrawal psychosis often experience an overwhelming sense of hopelessness. Some believe they will not survive withdrawal. Others get to a point where they see no hope for happiness or good health once the withdrawal is complete.

Depression

It is very common for morphine addicts to experience moderate to severe feelings of depression during withdrawal. The depression can be strong enough to encourage a patient to make decisions he or she would otherwise not make.

Disconnected thinking

Morphine withdrawal psychosis tends to create a pattern of disconnected thinking. The patient will demonstrate a series of random thoughts that do not seem to make any sense together. He or she might also fail to understand what is going on at the moment.

Paranoia

Though rare, some cases of morphine withdrawal psychosis produce feelings of paranoia. Such feelings are considered the most dangerous feelings of psychosis. Paranoia can lead people to take extreme actions to protect themselves.

The biggest concern of morphine withdrawal psychosis is that it makes a person unpredictable. Because the psychosis exhibits itself as a psychological condition that disconnects a person from reality, one can never be sure how a patient in the throes of psychosis will act. Decisions can be irrational; reactions to withdrawal symptoms can be emotionally charged; patients can turn on their caregivers at a moment’s notice.

The good news is that extremely dangerous cases of morphine withdrawal psychosis are rare. In most people, psychosis is manageable and short-lived. Treatment providers can prepare for the onset of psychosis by watching for some of the early warning signs. Those signs include disorganised thoughts, increased fear and anxiety, impaired speech, and impaired writing ability.

Medical Detox from Morphine as Part of a Whole Treatment Plan

From a medical standpoint, addiction is considered a chronic brain disease with a high potential for relapse. Furthermore, addiction and dependence are two different things. Those differences will be discussed later in this guide. For the moment though, the nature of addiction itself requires a comprehensive treatment if the best possible outcome is to be achieved.

To that end, medical detox from morphine is best utilised when it is part of a whole treatment plan that treats both body and mind. Remember that morphine addiction is a disease that affects both mind and body. It affects the way the brain physically works; it affects how other parts of the bodywork; it affects the thoughts and emotions.

Medical detox is considered a stepping stone to full and complete recovery. It is not a method of recovery in and of itself. Although there are exceptions to the rule, very few people can completely overcome morphine addiction after undergoing detox alone. Detox usually has to be followed by psychotherapeutic treatments that realign the mind, thoughts, and emotions with a body recently cleansed of morphine.

Here’s what you need to know about medical detox as a stepping stone to psychotherapeutic treatment:

  • It is called ‘medical detox’ because it is approached from a medical standpoint that views addiction as a brain illness.
  • Prescription medications are utilised during withdrawal to stabilise the patient and reduce withdrawal symptoms.
  • Patients are monitored by doctors and nurses around the clock. Medical emergencies are handled immediately.
  • The patient’s overall health and continued stability are the most important priorities during withdrawal.

The next section of this guide will explain the morphine withdrawal timeline in more detail. Understand that when medical detox is part of a comprehensive treatment for morphine addiction, it is just the first step in a lengthy process. Successfully completing detox sets the patient up to transition into extensive psychotherapy.

Psychotherapeutic treatments can last from several weeks to several months, depending on how a patient responds. These treatments are necessary to align the mind with the newly detoxified body. Without psychotherapeutic treatment, the chances of relapse are significantly higher.

Also, note that there are non-medical options for morphine detox. One option is cold-turkey detox, which is rare in the UK in this day and age. Another option is detoxing via an outpatient clinic where pharmacological intervention is minimal. Patient health is examined with every visit to the clinic, but it is not monitored 24 hours a day.

Morphine Addiction Detox

What you can expect from morphine addiction detox under normal conditions includes the withdrawal timeline. Please note that what you read here is a general description. Your experience may differ depending on the severity of your addiction and other factors.

As a general rule, treatment centres want to complete detox as quickly as possible without endangering the patient or significantly increasing the chances of relapse. Ideally, we would like to see detox completed in 7 to 14 days. That is not always possible. It is up to doctors and mental health professionals to determine what is best for each patient.

Morphine Withdrawal Timeline

Before the morphine addiction detox even begins, the patient is evaluated both physically and psychologically. The evaluation team will decide how best to proceed. In a medically supervised setting, the patient normally receives a dose of morphine or one of the other stabilising drugs mentioned earlier to get the process started. Early withdrawal symptoms usually begin to manifest themselves within 6 to 12 hours of that dose.

If one of the longer acting alternative medications is used, it may take up to 30 hours for withdrawal symptoms to begin. So in summary, withdrawal symptoms begin anywhere from 6 to 30 hours into the detox process, according to whatever pharmacological modality the treatment team chooses to follow.

Once withdrawal symptoms begin in earnest, they gradually increase in intensity. They typically reach their peak somewhere around the third or fourth day. Within 72 hours of the start of detox, patients begin experiencing the most severe nausea, vomiting, stomach cramps, and drug cravings they will experience throughout the entire process. How long do these withdrawal symptoms last? It depends on the individual.

While peak normally occurs within 72 to 96 hours, it generally takes longer for the symptoms to completely subside. Some patients continue experiencing symptoms for about a week. Others can go two or three weeks. The important thing to note is that, regardless of how long the symptoms linger, they eventually disappear. They may peak at 72 hours, but that peak is followed by a gradual decline.

When Detox Takes Longer
There are cases in which a medical team is especially concerned about a patient’s reaction to withdrawal. That may result in a more gradual approach that utilises more medication than would otherwise be used. Facilitating a more gradual withdrawal can be safer and more comfortable for the patient, but it also prolongs the detox process.

When detox takes longer it is because a person has an especially severe addiction and/or experiences withdrawal symptoms severe enough to seriously endanger the person’s health. If it takes longer to detox in order to keep the patient safe, medical staff are willing to go that route.

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Morphine Detox Protocol

A medical protocol is a detailed plan that lays out exactly how treatment will progress. Despite the generally rigid nature of medical protocols, they do have to remain somewhat flexible to account for patient reactions. This is especially true when you are talking about morphine detox. Medical staff come up with a treatment plan that gets things moving in the right direction. The treatment plan may have to be modified along the way, depending on how the patient responds.

The first step is to stabilise the patient. In the arena of detox and withdrawal, this is a reference to the patient’s normalised vital signs and that the medical team has set a pharmacological benchmark for beginning withdrawal.

The withdrawal process is the second step of a morphine detox protocol. A doctor will prescribe a regimen of medications that will slowly wean the patient of morphine or the substitute drug. As the patient progresses through detox, the protocol calls for lower and lower doses.

The next component of a morphine detox protocol is to utilise additional prescription and over-the-counter medications to control withdrawal symptoms. This is where the patient’s programme has to be extremely flexible. For example, diazepam is a benzodiazepine that may be used to treat insomnia. However, it cannot be used on patients with a previous history of benzodiazepine abuse or dependence.

The last stage is learning how to control cravings so as to prevent relapse.

Physical Dependence vs. Addiction

The terms ‘dependence’ and ‘addiction’ are used interchangeably by both patients and treatment providers alike. While this is normally not a problem, it is important to understand that the two conditions are separate and distinct. Simply put, physical dependence and addiction are not the same thing. Your body could be dependent on morphine without you being an addict.

Physical dependence is a medical condition diagnosed as a result of observing how the body responds to a given substance. Where morphine is concerned, physical dependence is established at whatever point the body is relying on having morphine in the system to maintain routine function. Dependence is normally associated with long-term tolerance.

Tolerance occurs when the body becomes used to a certain level of morphine in the system. You can recognise tolerance by having to take more morphine in order to experience the same effects. As tolerance to morphine increases, the body is relying on it more and more. This eventually leads to physical dependence.

Addiction is an entirely separate matter. It is sometimes linked to psychological dependence, although it doesn’t have to be. You can also be psychologically dependent without being addicted. So what is the difference? What makes addiction separate and distinct? The answer is encapsulated in a single word: compulsion.

A person who is dependent but not addicted still has some ability to say ‘no’ to morphine. It may be extremely uncomfortable to do so, but the person still has enough control over mind and body to refuse to take the next dose. A morphine addict no longer has that control. Rather, he or she takes morphine compulsively; the addict cannot help him or herself.

A key difference between dependence and addiction is observed in the patient’s reaction to the negative consequences of morphine use. An addict will compulsively continue taking the drug despite knowing that doing so is harmful. It will not matter that morphine use is causing physical and mental harm. It will not matter that the user’s behaviour is tearing apart the family and alienating friends. The addict will show no concern over a lost job, failing finances, and even the need to engage in criminal activity to pay for morphine.

Both Are Serious Conditions

We do not want to give the impression that being dependent is better than being addicted. It is not. Both are serious conditions requiring comprehensive medical treatment. Moreover, it is entirely possible for untreated dependence to eventually lead to addiction. So it’s not wise to reject medical treatment because a person is not yet addicted.

The big difference with addiction is that the addict has abandoned all concern for his or her own welfare. His/her addiction drives him/her to continue using morphine despite the consequences. This makes addiction the most serious form of drug abuse for reasons that should be obvious.

Morphine Overdose

Morphine overdose is rare in a clinical setting. Let’s say you’re in the hospital receiving morphine to help control post-surgical pain. Every dose you are given is monitored and tracked by your medical team. Your prescription is such that the amount of morphine you are given is kept at a minimal level.

When you go home from the hospital, you might continue using morphine until the pain subsides. Again, overdose is unlikely because you are following the instructions included with your prescription to the letter. The prescription has been written in such a way as to prevent any chances of overdose. But what if you do not stick to the doctor’s instructions?

Morphine overdose occurs when a person takes too much morphine in too short a time. It is recognisable by a set of symptoms that include breathing difficulties, blue lips and fingertips, loss of verbal and motor skills, and even loss of consciousness. The biggest risk of morphine overdose is hypoxia.

Hypoxia is a medical condition that occurs when the brain does not get enough oxygen. Because morphine slows down respiration, hypoxia is a very real concern in an overdose situation. A person’s breathing could become so shallow that oxygen intake is severely inhibited. This could lead to brain damage as a result of the brain being starved of oxygen.

People who lapse into a coma as a result of a morphine overdose are at significant risk of hypoxia. There have been cases where patients have lapsed into a coma and never come out of it. Therefore, the number one priority in a morphine overdose situation is to stabilise the patient’s breathing.

There are two primary ways to treat morphine overdose:

Naloxone

Also distributed under the brand name Narcan, naloxone is a non-selective and competitive opioid receptor antagonist. In simple terms, it reverses the effects of morphine by binding to opioid receptors and preventing any further activation by the morphine. Once it is injected or inhaled, it works within minutes.

Activated charcoal

Activated charcoal can be administered in a number of different ways. Rather than reversing the effects of morphine though, it prevents the body from absorbing any additional morphine. Activated charcoal essentially interrupts the overdose and gives the body a chance to respond to the morphine already in the system.

It would seem as though naloxone would be the obvious first choice for treating morphine overdose. Normally it is, but its effectiveness is reduced in proportion to any delay in administering it. In other words, the longer it takes to receive a dose of naloxone, the less effective the drug is. In some patients, the naloxone is not an option due to extenuating circumstances. Activated charcoal is used instead.

Morphine Addiction Treatment and Rehab

Morphine addiction is a serious problem requiring comprehensive treatment. If you or someone you know is suffering from a morphine problem, please know that treatment and rehab options abound across the UK. There is both inpatient and outpatient treatment if you are willing to commit yourself to accessing it. And don’t forget, a comprehensive and medically-based treatment offers you the best possible chances of permanently overcoming your morphine addiction.

Morphine Addiction Withdrawal and Detox Statistics

Hard data related to morphine addiction withdrawal and detox is hard to come by. The primary reason is that those institutions compiling the data tend to lump morphine in with all other opiates and opioids. And even when morphine is addressed separately, it is almost always linked with heroin for statistical purposes.

Having said that, there are some very surprising statistics about opioids that certainly apply to morphine addiction treatment and rehab. For example, opioid abuse represents the single most harmful form of drug abuse in the UK. In 2015, 8 out every 1,000 people in the UK were considered high-risk opioid users.

The prevalence of opioid abuse suggests a commensurate prevalence of opioid-related deaths. Numbers from 2016 prove as much. Of the total 3,744 deaths related to drug poisoning reported in 2016, more than half were related to morphine or heroin. That means more than 1,800 people died as a result of opioid poisoning in 2016.

Here are some additional statistics reported by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) in their UK Country Drug Report 2017:

  • The UK was home to 330,445 high-risk opioid users in 2015
  • There were 142,085 patients receiving opioid treatment in 2015
  • Opioid treatments made up 42% of the total drug treatments in 2015.

In terms of opioid treatment itself, the EMCDDA report shows that only about 33% of the clients treated for opioid abuse in 2015 were first-time patients. Some 71% of them received a methadone-based treatment while the remaining 29% received a buprenorphine-based treatment.

Frequently Asked Questions

How does morphine withdrawal affect my health?

In the short-term, morphine withdrawal will create a set of symptoms that will make you extremely uncomfortable. Some of those symptoms can result in long-lasting effects on your physical and mental health. For example, the shallow breathing associated with morphine withdrawal could lead to hypoxia and eventual brain damage. As long as morphine withdrawal is conducted in a medically supervised setting though, your risk of experiencing a long-term negative impact on your health is minimal.

Will my information be kept confidential?

Medically supervised treatments in the UK are kept confidential. Your medical information will be shared only among those clinicians and support staff who have a medically necessary reason to utilise it. No one outside the treatment clinic will know about your treatment unless you choose to inform them. As for any personal information collected for the purposes of treating you, it is kept safe and secure at all times.

Am I addicted?

You may be addicted to morphine if you demonstrate tolerance, physical dependence, and the compulsive desire to use the drug. If you use morphine without any regard to the damage it is causing, that is another sign of addiction. Unfortunately, an addiction cannot be diagnosed through a guide like this. You need a medical and psychological evaluation conducted by an experienced professional.

How serious is morphine detox?

Detoxing from any drug is considered a serious medical scenario. Morphine detox is especially serious because of the very real risk of hypoxia. Detoxing from morphine also carries with it the risk of a condition known as morphine withdrawal psychosis. This is a very serious condition that could lead to significant injury or death.

Can medications help me detox from morphine?

Yes, there are a number of medications treatment centres can use to help facilitate a gradual and less risky detox. Two of those drugs are opioid substitutes while a third is a completely different form of analgesic that is not even a controlled substance. In addition, there are both prescription and over-the-counter medications that can be administered to treat withdrawal symptoms.

Can I die from morphine withdrawal?

Although death is rare for morphine withdrawal, it is certainly not out of the question. Respiratory arrest, cardiac arrest, and morphine withdrawal psychosis can all lead to critical medical conditions that eventually result in death. For this reason, it is never advised that a person attempting to withdraw from morphine do so outside of the supervision of medical professionals.

How do I detox from morphine?

The safest and most comfortable way to detox from morphine is through the tapering (i.e., gradual) method. This method utilises either lower doses of morphine or another substitute drug to gradually bring you through withdrawal. The goal is to continue tapering the amount of medication you receive until you are eventually drug-free.

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