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Using morphine under palliative care (where it’s essential to make the patient feel comfortable towards the end of their life) can worry some people. Morphine is classified under opioids and relieves immense pain, but it is considered a regulated and controlled substance due to its habit-forming ability. When regulated within a hospice or hospital, the patient’s care team can find a comfortable spot while avoiding adverse side effects.
What Does Morphine Do To The Body?
Morphine is a commonly used medicine to relieve moderate to severe pain and its effects (shortness of breath, elevated heart rate, and higher blood pressure). It can be administered through the IV or as pills and change how the nervous system and brain respond to pain. They’re used in emergency and palliative care depending on the patient’s needs.
How Is Morphine Used for End of Life?
Morphine is one of the main hospice drugs used for the end of life. It’s considered a gold standard in pain management and is provided to patients depending on their pain level until their time of death. It is administered using a low dose which can be increased slowly if necessary. Some patients may never require it, while others need it for a long time. A person’s health declines due to their illness, whether morphine is administered or not.
What Are Morphine’s Side Effects in Hospice Patients?
Below are some effects one can expect when given a small dose of morphine for the first time.
- Constipation: This is a common and persistent effect that may advance with higher, regular doses.
- Nausea/vomiting: This is common at the beginning but lessens within 1-2 days. Talk to your nurse if it persists for longer.
- Stomach pain/cramps: Abdominal cramping is also common when you first start using morphine but should stop after two days.
- Dry mouth: Practicing good oral hygiene will stimulate saliva production, which can help alleviate this side effect.
- Drowsiness: This is a common initial side effect until your body adapts to the level of morphine within it. If the side effect bothers you, you can talk to your nurse about receiving a lower dose.
- Lightheadedness or dizziness: remember to stand, lie down, or sit slowly while on this medication to avoid feeling dizzy
- Itchy skin: itchiness is a rare side effect that some patients experience. You should inform your provider if it is persistent and causes discomfort
How Much Morphine Can Kill You?
As with most medications, a high dose for your body can cause an overdose. The actual amount can vary depending on the patient’s medication history, specifically with opioid use. Common signs of an overdose include cold, clammy skin, slow and regular breathing, and fainting with extreme difficulty waking up without any medical assistance.
Does Morphine Cause Death?
In most morphine end-of-life administration, patients receive a “last dose,” which is the final medication they receive before the body naturally passes. This final dose is the same medicine and dosage the patient previously received. The person’s passing can happen anywhere from minutes to hours after morphine is delivered. Observers by the bedside may wonder whether morphine hastens death, but this is far from the truth.
There is no evidence that morphine quickens a person’s passing if they receive the correct dose. In fact, there is some research to suggest that many opioids used at the end of life medicine (e.g. hospice morphine treatments) may lengthen a person’s life. People at the end of their time may have difficulty breathing due to their declining condition and immense pain; alleviating these symptoms with opioids decreases the patient’s stress and improves their breathing.
In the last moments of one’s life, their breathing quickens and becomes shallower. The lungs and diaphragm are weak during this time, much like the other body muscles. While it could appear like the person is quickly intaking gasps of air, they are not short of breath. After a while, the breathing continues to be fast but is now irregular with longer and longer pauses. They have passed on when they do not draw breath after a pause.
Increased breathing and gasping are not side effects of morphine but are a clear sign of distress and one of the few indicators of the final hours of the natural death process. Morphine or other pain medication can be administered to alleviate the effects of one’s passing process, but it does not cause or speed up the process. There are clear and recognizable side effects when a person naturally passes away and when they die of an overdose.
Here at All American Hospice, all medical employees are trained to put the needs and concerns of the patient first. We aim to help patients achieve maximum comfort and dignity through our services. We are dedicated to ensuring patients and their families are at ease during their time with us.
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