Is morphine addictive?
My father (who lives with us) had a cancer removed two years ago, but now it has shown up again - in his bones. The bone pain has become more severe recently, and he has been given morphine tablets and liquid. This gives good relief; but will he become addicted to the morphine? Will he need more and more? Will it make him drowsy and “spaced out”? Is it safe for him to drive?
Answer:
Morphine is the best painkiller for relieving the severe pain sometimes caused by cancer. It is routinely used when milder painkillers are no longer effective, and it works by blocking perception of pain signals by the brain.
Addiction doesn’t occur when morphine is used for pain relief: addiction and dependence only develop when morphine is abused for its mood-altering properties. If a cancer patient’s pain is controlled by other means, such as radiotherapy, it is often possible to reduce or stop the morphine dose.
Patients don’t need more and more morphine for the same amount of pain control, most people can remain on the same dose. However, if the pain does get worse, a higher dose may be needed to give full relief. Your doctor will advise you if the dose needs to be adapted.
Good pain relief is essential for comfort and enjoyment of life. It is important to take morphine regularly and in sufficient amounts to control pain, and it does no good to try and cut down the dose just for the sake of taking less. Patients may be given liquid morphine for “topping up” if pain flares up between doses of the long-acting tablets, if so, they should use it and not try to do without. There may be slight drowsiness for the first few days on treatment — which may be the patient catching up on sleep lost through pain, as well as from the effect of the drug. After this, most patients are as bright and alert as usual. If drowsiness continues, consult your doctor, something else may be causing it. Other common side effects of morphine include nausea for a few days after starting, and constipation, which can be an on-going problem. Patients must increase their intake of fibre and fluid to combat this.
Taking morphine doesn’t disqualify a person from driving, unless it affects reaction time and overall alertness. But patients are usually advised to stick to short drives, when traffic is quieter, and to avoid driving at night, in bad weather, on expressways, in peak traffic and, of course, after alcohol, which can cause increased sedation when taken with morphine.
Perhaps you could go for a drive with your father at a quiet time of day, to see how he handles it, and if there is any doubt about his capability to drive his usual standard, advise him to play safe.
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