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Morphine is a non-synthetic narcotic with a high potential for abuse and is the principal constituent of opium. It is one of the most effective drugs known for the relief of severe pain. In the United States, a small percentage of the morphine obtained from opium is used directly for pharmaceutical products.

Today, morphine is a Schedule II drug under the Controlled Substances Act of 1970, meaning that it has high potential for abuse, but can be administered by a doctor for legitimate medical uses such as surgeries.

Abtract

Morphine is a non-synthetic narcotic with a high potential for abuse and is the principal constituent of opium. It is one of the most effective drugs known for the relief of severe pain.

In the United States, a small percentage of the morphine obtained from opium is used directly for pharmaceutical products. The remaining morphine is processed into codeine and other derivatives.
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Street names

Dreamer
Emsel
First Line
God’s Drug
Hows
M.S.
Mister
Blue
Morf
Morpho
Unkie
[3]

Brand Names 

MS-Contin®
Oramorph SR®
MSIR®
Roxanol®
Kadian®
RMS®
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History

Morphine was discovered as the first active alkaloid extracted from the opium poppy plant in December 1804 in Paderborn, Germany, by Friedrich Sertürner.The drug was first marketed to the general public by Sertürner and Company in 1817 as an analgesic, and also as a treatment for opium and alcohol addiction. Commercial production began in Darmstadt, Germany in 1827 by the pharmacy that became the pharmaceutical company Merck, with morphine sales being a large part of their early growth.
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Pharmacology

The chemical formula for morphine is: C17H19NO3

Morphine appears to mimic endorphins. Endorphins, a contraction of the term endogenous morphines, are responsible for analgesia (reducing pain), causing sleepiness, and feelings of pleasure. They can be released in response to pain, strenuous exercise, orgasm, or excitement.

Morphine is the prototype narcotic drug and is the standard against which all other opioids are tested. It interacts predominantly with the μ-opioid receptor. These μ-binding sites are discretely distributed in the human brain, with high densities in the posterior amygdala, hypothalamus, thalamus, nucleus caudatus, putamen, and certain cortical areas. They are also found on the terminal axons of primary afferents within laminae I and II (substantia gelatinosa) of the spinal cord and in the spinal nucleus of the trigeminal nerve.

Use

Morphine is primarily used to treat both acute and chronic severe pain. It is also used for pain due to myocardial infarction and for labor pains. There are however concerns that morphine may increase mortality in the setting of non ST elevation myocardial infarction. Morphine has also traditionally been used in the treatment of the acute pulmonary edema. A 2006 review however found little evidence to support this practice. Immediate release morphine is beneficial in reducing the symptom of shortness of breath due to both cancer and non-cancer causes.Its duration of analgesia is about 3-4 hours when administered via the intravenous, subcutaneous, or intramuscular route and 3-6 hours when given by mouth. Morphine is also used in slow release formulations for opiate substitution therapy (OST) in Austria, Bulgaria, and Slovenia, for addicted patients who cannot tolerate the side effects of using either methadone or buprenorphine, or for addicted patients who are "not held" by buprenorphine or methadone. It is used for OST in many parts of Europe although on a limited basis.
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Scheduling

Today, morphine is a Schedule II drug under the Controlled Substances Act of 1970, meaning that it has high potential for abuse, but can be administered by a doctor for legitimate medical uses such as surgeries. 
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Psychological and physical addiction liability

Morphine is a potentially highly addictive substance. It can cause psychological dependence and physical dependence as well as tolerance, with an addiction potential identical to that of heroin. A very serious narcotic habit can develop in a matter of weeks, whereas iatrogenic morphine addiction rates have, according to a number of studies, remained nearly constant at one case in 150 to 200 for at least two centuries. In the presence of pain and the other disorders for which morphine is indicated, a combination of psychological and physiological factors tend to prevent true addiction from developing, although physical dependence and tolerance will develop with protracted opioid therapy.

In controlled studies comparing the physiological and subjective effects of injected heroin and morphine in individuals formerly addicted to opiates, subjects showed no preference for one drug over the other. Equipotent, injected doses had comparable action courses, with no difference in subjects' self-rated feelings of euphoria, ambition, nervousness, relaxation, drowsiness, or sleepiness.
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Long term effects

The general long term effects of morphine include the effects that persist over long-term use of morphine are the drug's primary side effects. Aside from relieving pain, morphine produces a host of psychological and physical side effects that are important to be aware of.

Persistent side-effects of morphine include mental impairment, euphoria, decreased appetite, reduction of physical performance, chronic constipation, and reduced or eliminated sex drive. Sleepiness or slurred speech are also to be expected when taking morphine for a long period of time, according to Medline Plus.
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Physical effects

Below is the list of effects which may be experienced by morphine addicted patients:

dizziness
lightheadedness
drowsiness
nausea
vomiting
constipation
diarrhea
loss of appetite
weight loss
changes in ability to taste food
dry mouth
sweating
weakness
headache
agitation
nervousness
mood changes
confusion
difficulty falling asleep or staying asleep
stiff muscles
shaking of a part of your body that you cannot control
double vision
red eyes
small pupils (black circles in the middle of the eyes
eye movements that you cannot control
chills
flu symptoms
decreased sexual desire or ability
difficulty urinating or pain when urinating.
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Withdrawal Effects

The withdrawal symptoms associated with morphine addiction are usually experienced shortly before the time of the next scheduled dose, sometimes within as early as a few hours (usually between 6–12 hours) after the last administration. Early symptoms include watery eyes, insomnia, diarrhea, runny nose, yawning, dysphoria, sweating and in some cases a strong drug craving. Severe headache, restlessness, irritability, loss of appetite, body aches, severe abdominal pain, nausea and vomiting, tremors, and even stronger and more intense drug craving appear as the syndrome progresses. Severe depression and vomiting are very common. During the acute withdrawal period systolic and diastolic blood pressure increase, usually beyond pre-morphine levels, and heart rate increases, which have potential to cause a heart attack, blood clot, or stroke.
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Medical Treatment options

Treatment for addiction to morphine pills or solutions usually is done with a taper. A taper is very effective in removing the medication from the patient’s body with little to no withdrawal during or following treatment. During a taper, the drug is stepped down over a period of days or weeks, from a whole dose to three-fourths of a dose, to half, and so on. In medical emergencies such as overdoses, there is an antidote that can be administered to help the patient prevent respiratory depression. An acute overdose can present in a number of ways, but can lead to coma and death. "Rehab facilities offer support during withdrawal by offering one-on-one psychotherapy or group therapy with others who are seeking to quit their drug addictions. During a stay at a rehab facility a patient will maintain as much normalcy as possible. Inpatients can spend time exercising and eating healthy meals. Both of these activities are part of the healing process that ultimately aims to help patients return to a normal, drug-free life.

Psychological treatment options

Psychological treatment may serve as a good suppliment in the process of detoxification. This helps the patients change their habits and behaviors, so that addiction in the future is not as likely to recur. A psychologist or psychiatrist is on call at many hospitals, major health clinics, and in private offices. A psychological dependency is most likely to be treated with therapy sessions while the patient is tapered off of the drug.

Psychological treament

When choosing a drug rehabilitation center, it is important to have an understanding of the programs available and the methods used. For example, if you want to try quitting cold turkey, you will want to find a rehab facility that respects your wishes, is experienced with this type of detox and is willing to provide the support you need. The range of options available when it comes to rehabilitation facilities is vast, so by performing a thorough search, you can find one that fits your needs.

Rehabs often address potential underlying issues that may have led to addiction in the first place. Although some people simply get hooked from one exposure to a drug, other people have addictive personalities. The stresses of life may lead some people to drugs and alcohol, and a rehab center can help teach patients stress management techniques. The ultimate goal of a rehab is to help each individual understand why addiction happens and how to prevent a relapse.

Related drugs

Opium
Codeine
Heroin
Methadone
Hydrocodone
Fentanyl
Oxycodone

Related synthetics

As morphine also belongs to the opiade family of drugs, its synthetic derivatives are same as that of heroin:

Acetyldihydrocodeine
Benzylmorphine
Buprenorphine
Desomorphine
Dihydrocodeine
Dihydromorphine
Ethylmorphine
Diamorphine
Hydrocodone
Hydromorphinol
Hydromorphone
Nicocodeine
Nicodicodeine
Nicomorphine
Oxycodone
Oxymorphone
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References

[1] http://www.drugs.com/monograph/morphine-sulfate.html
[2] http://www.ahjonline.com/article/S0002-8703(05)00149-3/abstract
[3] http://www.druglibrary.org/gh/morphine.htm
[4] http://www.ncbi.nlm.nih.gov/pubmed/20722311
[5] http://www.ehow.com/about_5558441_longterm-effects-morphine.html
[6] http://www.emsb.qc.ca/laurenhill/science/morphine.html
[7] http://www.bestbets.org/bets/bet.php?id=376