The NHS state (www.nhs.co.uk,2017) that morphine and similar drugs (such as fentanyl, oxycodone and buprenorphine) are the strongest painkillers available. Morphine is recommended to be used as part of a long term plan to manage pain and must be prescribed by a doctor.
Morphine is a very addictive drug due to its relation to opium however when used to manage pain, users do not usually become addicted. Bengal Province in India was the World’s largest producer of opium when it was conquered by the British in 1773. The Indian poppy fields were now under British control as a result, Britain decided to start trading opium as a way of addressing the trade imbalance between China and Britain. (News-medicalnet, 2010) Opium addiction soon spread across China and began what is known as ‘The Opium Wars’ in which the Chinese were defeated by the British.
The exact date of discovery of morphine is disputed, however it is generally accepted by medical historians that the basis for opium’s potent effects was discovered somewhere between the years 1805 and 1816 by a pharmacist’s assistant called Friedrich Wilhelm Sertürner. Sertürner was intent on learning why opium produced the effects that it did, this intent led to an experiment where he was able to isolate a yellowish-white crystalline compound from raw opium by immersing the drug in hot water and ammonia. (Busse, 2006) Unaware of what he had discovered and what the effects may be Sertürner first tested the new drug on some dogs. All of said dogs died as a result of this experiment and so he tested the drug rather foolishly out on his own three sons and himself. From this experiment, he discovered that this new compound, like opium, could not only relieve pain and induce euphoria but it also became apparent that, in sufficient doses, this compound would produce a dysphoric feeling, respiratory depression, nausea, vomiting, depression of the cough reflex, and constipation. The most important discovery however was that this compound was approximately ten times as potent as opium in relieving pain, therefore less of the drug was needed to produce the same effect. (Busse, 2006) Sertürner named the new discovery Morphine after the Greek god of dreams, Morpheus.
Morphine began to gain popularity as a medicine in the mid 19th century, in particular with pharmaceutical companies as they began to hear of morphine’s potential. The general public were not so keen as they had begun to become educated on the use of drugs and their effects. In order for the pharmaceutical companies to be able to sell morphine they needed to come up with another way of delivering the drug other than orally. At the time, it was believed that drug dependence was a result of ingestion rather than the drug having a detrimental effect on the recipient’s brain.
Opinions began to change with the invention of the hypodermic needle. The hypodermic needle was discovered In the 1850s by a French veterinary surgeon, Charles Gabriel Pravaz and a Scottish doctor, Alexander Wood. They developed a syringe which had a hollow needle fine enough to pierce the skin. Initially the syringe barrels were made of metal, but by 1866 they were made from glass (the needles remained metal). The change from a metal barrel to a glass barrel enabled doctors to see what medication remained in the barrel. (Sciencemuseumorguk, 2017)
With the introduction of the hypodermic needle came a more relaxed attitude to morphine and its consumption. Dependence on morphine became known as ‘Soldiers disease’ due to the popularity of its use amongst those at war. Soldiers would often return from war addicted to morphine and its effects. This addiction quickly spread throughout the general public causing vials of morphine and hypodermic needles to be found in most medicine cabinets within the home.
In response, the Harrison Narcotics Tax Act of 1914—the first major piece of U.S. legislation to control the sale and use of opiates—was passed. The act passed restrictions on the distribution and sale of heroin and opium, as well as cocaine. (Historycom, 2017) The Harrison Narcotics Act restricted the recreational use of morphine by the general public. It in no way meant that it was not available, just that morphine was now a taxed substance and required lawful documentation in order to be distributed.
In 1970, the US government passed ‘The Controlled Substance Act.’ Under this act, morphine is considered a stage 2 substance. Stage 2 substances are defined as ‘The drug has a high potential for abuse. The drug has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse of the drug may lead to severe psychological or physical dependence.’ (Drugscom, 2017)
According to the UK legislation, ‘Misuse of Drugs Act 1971’, morphine is defined as a Class A drug. Unlawful possession of a class A drug in the UK can lead to up to seven years in prison, an unlimited fine or both. (Nationalarchivesgovuk, 2017)
The use of morphine is an integral part of clinical medicine in the area of pain relief and management particularly for those receiving palliative care. The accidental discovery of morphine back in the 18th century has allowed patients ranging from those soldiers caught in war to post-operative patients to receive effective pain relief. Unfortunately, due to its euphoric effects, morphine is also commonly used illegally by recreational drug users.