Morphine is a common medication that we use for patients that utilize hospice care. Morphine is an opioid agonist, meaning that it activates opioid receptors within the body to decrease pain. As a medication, it has been used for many years to treat both acute (short-lasting) and chronic (long-lasting) pain. Unfortunately, due the common use of morphine at the end-of-life, it has developed a “bad reputation.” Not only do some patients have fears; family members do as well. When family members are afraid, they sometimes tell their loved one to not take morphine. This can cause increased despair and confusion for the patient who wants to respect family wishes but also is very uncomfortable.
One of the most common myths I hear about morphine from patients or their family is that it makes you stop breathing. One of the side effects of morphine is decreased respiratory drive, meaning it can slow a patient’s breathing. For hospice patients, we are careful about the amount of morphine that is prescribed so that the patient is not to the point where they stop breathing. Because it can slow a patient’s breathing, we use morphine when a patient has dyspnea, or the feeling of shortness of breath. This is a comfort measure that is common in hospice, as shortness of breath becomes more common as the disease progresses.
In addition to using morphine for shortness of breath, its main reason for use is pain management. Another myth that is common is that it is only effective for a little while, or if it is started too early, then it will not work later. When anybody takes an opioid medication for longer than seven days, the body develops a tolerance to the medication. This means that the patient may require an increased dose of morphine to have the desired effect, but it will still work. We also have other opioids available if morphine does become ineffective for some reason. These include hydrocodone, oxycodone, hydromorphone, and methadone. It is important to remember that when used properly, morphine is not only relatively safe, it is also very effective in treating multiple symptoms at the end of life.
Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat,
By: Timothy Cruz, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care, Hospice of Southern Illinois
October is American Pharmacists Month and we are proud to present to you an educational blog series throughout the month by, Timothy Cruz, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care. Our series will help expand your understanding of the use of medications at the end-of-life.