Learn more about the safety of pain medications like morphine used during end-of-life care.
You or your loved ones may have questions and concerns about the medications used during palliative and hospice care. That makes sense, since these medications are often very powerful, and are essential to relieve pain and enhance comfort during advanced stages of illness.
One such medication is morphine, an opioid often prescribed when other pain relievers are no longer working. Due to some misconceptions, family members sometimes have concerns that morphine may speed up the dying process. But when used in appropriate doses, morphine is a safe and effective way to ease pain while not hastening death.
Read on to learn more about morphine, what purposes it serves, how providers ensure it’s used safely, and the potential risks to be aware of.
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What Is Morphine?
Morphine is an opioid that blocks pain signals from traveling through the nerves to the brain. It’s a strong pain medication often used at the end of life to maintain comfort and ease anxiety. The drug can be taken by mouth in the form of morphine pills or intravenously as liquid morphine.
Doctors also sometimes prescribe morphine injections or suppositories. Morphine can be habit-forming and can be dangerous at high doses, so it’s important to take it only under the care of a doctor.
Does Morphine Speed Up the Dying Process?
It’s a common misconception that morphine hastens death, but there’s no evidence that morphine speeds up the dying process. It can cause harm when taken inappropriately, causing concern about its safety. Side effects like sedation, confusion, and hallucinations can be confused with hastening death.
Another possible cause of the misconceptions about morphine and death is that morphine is often given at the end of life. Therefore, it may be the last drug given to a patient. This might lead the family to incorrectly believe that morphine caused the death, particularly if it was given moments before the time of death.
Morphine Uses: Why Morphine is Used to Treat Pain at the End of Life
When people are nearing the end of life, pain can become severe and even unbearable. In fact, research shows that pain increases in the last four months of life. Morphine is considered the gold standard of treatment to ease suffering from moderate to severe pain. It can even be effective when other medications are no longer working.
Note that it’s not the stage of illness that determines when morphine is given, but the level of pain. Some people may never need morphine, while others may need to be on it for longer periods of time.
Other morphine uses can include easing the feeling of shortness of breath, as well as the anxiety this can lead to. Difficulty breathing can be extremely distressing, both to experience and to watch a loved one endure. Reducing pain and easing breathing problems can bring much-needed comfort at the end of life.
Will I Become Addicted to Morphine?
Morphine can become habit-forming, particularly with long-term use and when taken inappropriately. Because of this, some may be concerned that they will get addicted when they’re given morphine in a medical setting or at the end of life.
But rest assured that palliative and hospice care providers are specially trained to administer safe and appropriate doses of morphine to their patients. As such, addiction to morphine in this setting is very unlikely.
Morphine Side Effects
While morphine used under a doctor’s supervision and taken as directed is considered generally safe, there are some risks to be aware of.
Like any medication, morphine can cause side effects. Some people may not have any side effects, while others experience minor effects. Serious side effects are rare but can occur.
Common morphine side effects include:
- Abdominal pain and cramps
- Dry mouth
- Mood changes
- Trouble urinating or pain when urinating
- Small pupils
Serious side effects of morphine occur in less than 1 in 100 people. If you or your loved one experiences any of the following while taking morphine, alert your doctor right away:
- Nausea and vomiting, along with weakness and loss of appetite
- Skin changes, such as a blue or purple color
- Trouble breathing
While rare, it’s also possible to have an allergic reaction to morphine. Signs include:
- Skin rash that may be red, itchy, swollen, or blistered
- Wheezing or trouble breathing or talking
- Tightness in the throat or chest
- Swelling in the face, lips, mouth, or tongue
Does Morphine Stop a Person’s Breathing?
In rare instances, morphine can lead to respiratory depression. However, when morphine is administered in controlled doses and carefully monitored, such as in a palliative or hospice care setting, the risk is exceedingly low.
At the end of life when pain medications like morphine are given continuously, there’s always a “last dose.” To family members at the bedside, it may seem like morphine was the cause of their loved one’s last breath, especially if a hospice specialist administers the final dose within minutes of death.
But it’s not the morphine that stops a person’s breathing. Rather the morphine was the last medication given before the death occurred naturally. Morphine is administered at a closely monitored dose to decrease any pain and discomfort the patient may experience during end-of-life care.
Here are answers to frequently asked questions about morphine and death.
How Much Morphine Do You Need for Palliative Care?
The amount of morphine needed during palliative care will be determined by your palliative care team. The amount may vary from person to person, depending on how much pain and other symptoms you have. Generally, doses start out low and are adjusted as needed.
What are the Signs of the Last Hours of Life?
During the last hours of life, the human body undergoes a number of changes. Signs that end of life may be approaching include lack of appetite, sleeping more, withdrawing from others, and increased pain.
In the final hours, there are usually changes in blood pressure, body temperature, and heart rate, as well as irregular breathing and color changes to the skin, which is usually purple or blue.
It’s natural to have concerns over the safety of medications like morphine during end-of-life care. However, know that in a controlled and carefully monitored setting like hospice care, it’s very rare that they would harm your loved one.
On the contrary, morphine can help ease your loved one’s pain and enhance their comfort. Furthermore, there’s no evidence that morphine speeds up death.
If you have any questions about the medication being given to your loved one, reach out to your care team.