Morphine: Boon and bane

The drug heroin is a semi-synthetic opioid which is twice as potent as opium. Fully synthetic opioids are fentanyl and methadone. An endogenous opioid is endorphin (endogenous +morphine = endorphin) which is synthesized within the human brain. Morphine acts in the brain by binding to opioid receptors, there mimicking the effect of endogenous opioids. This inhibit s the transmission of the pain stimulus. Morphine has a dampening and anxiolytic effect.

How were morphines used in the past and what is the current status? For thousands of years, people have used opium as curative medicine. In 1805, the German pharmacist Friedrich Sertürner extracted morphine for the first time, paving the way for its primary use as a painkiller . However, after more and more people became addicted to morphine, in the late 19th century heroin was synthesized as the first attempt towards a less addictive alternative. Nowadays, the synthetic opioid methadone can be prescribe d to alleviate withdrawal symptoms from heroin without creating an intense high.

Morphine is still used in medicine today. Although the body release s endogenous opioids when stressed or to supress pain, the body‘s own resources are quickly exhausted when the pain is severe . Opioids are often used as a component of pain treatment for cancer patients to avoid or to treat breakthrough pain . Otherwise, opioids are only prescribed when other pain treatments have not worked properly (including painkillers with other agents such as Ibuprofen or Paracetamol). Very high potency opioids are only prescribed if there are no alternatives.

What side effects do opioids have? Side effects of opioids (morphine) include nausea , vomiting , constipation , drowsiness , exhaustion , or menstrual disruption . Morphine overdose can be lethal . It can cause contraction of the pupils, fall in blood pressure, and extremely reduced breathing caused by the dulling effect on the respiratory centre (which might lead to apnoea). In the case of an overdose, naloxone is administer ed.

Prolonged use can lead to physical and psychological addiction. After continuous intake of morphine, the body gets used to the dose and builds additional opioid receptors. The desire for a greater dose can be developed. Under medical supervision and with controlled doses that are not increased, patients do not usually develop a psychological dependence, even if the body starts to become dependent on the medication. It is important to continuously check the current dose and the necessity of the opioid treatment; as well as combining it with other pain-relieving therapies.

Withdrawal symptoms vary from unrest, lack of energy, headaches, sweating, yawning , goosebumps, craving and insomnia, stomach ache, diarrhoea, nausea, vomiting, high blood pressure, tachycardia, flu-like symptoms, anxiety, and psychotic symptoms. To avoid withdrawal symptoms, opioids have to be reduced gradually.

What about Fentanyl? An example of a drug crisis Between July 2021 and June 2022, about 107,000 people died from fentanyl overdoses in the USA, surpassing the US crack cocaine epidemic of the 1980s and 90s. Opioids are responsible for most fatal overdoses in the US. A major factor in the rise of fentanyl use is that it is much cheaper than opiates and other opioids because it is completely synthetic and therefore does not require plants for its production.

Fentanyl is an analgesic that is 100 times more potent than morphine. It is injected intravenously or consumed via patches (it is liposoluble ). Fentanyl is only legally available on prescription. Often, the trigger for addiction is the prolonged prescription of fentanyl due to intense pain. In the US, opioids are less strictly regulated than in the European Union.

Even though the fentanyl crisis is currently bigger in the USA than in Germany, the drug has already arrived in Europe and Germany. Fentanyl is often mixed with heroin (also verified in some cases in Germany). US Secretary of State Antony Blinken has recently warned that the US national fentanyl crisis could spread to the rest of the world.

EXERCISE:

1. In 1805, the German pharmacist Friedrich Sertürner extracted morphine for the first time, leading to its primary use as a painkiller. A) True B) False

2. Side effects of opioids (morphine) include: A) Disruption of the menstruation B) Nausea C) Amnesic aphasia D) Vomiting E) Drowsiness

3. Our body releases opioids when we are stressed or to supress pain. A) True B) False

You’ll find the answer below.

BIBLIOGRAPHY 1. https://nida.nih.gove 2. www.dhs.de 3. www.dict.cc 4. www.nytimes.com 5. www.spektrum.de 6. www.webster-dictionary.org

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTL. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten. Kontakt: mail@lobitz-seminare.de www.lobitz-seminare.de

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Lösung für Exercise:

1. A)

2. A), B), D), E)

3. A)

Morphine: Boon and bane

How were morphines used in the past and what is the current status?

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Morphine: Boon and bane

How were morphines used in the past and what is the current status?

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