Talk:Morphine

Overdose

I've read in another article that there have been people allegedly executed by morphine injection; perhaps this article could benefit from covering that topic a little bit-- or at least mentioning that such a thing is possible. ekedolphin July 6, 2005 04:12 (UTC)

Morphine, used alone, is an unreliable agent for euthanasia (and by extension, for capital punishment). Unexpectedly high doses can be tolerated by certain people, especially those who are past users of opioids (this would apply to many persons under consideration for either euthanasia or capital punishment). Yet morphine could probably play a more important role in drug cocktails used in sanctioned killing. Morphine is a CNS depresssant with a mechanism of action very different (and at least additive) to that of the barbiturates which are the mainstay of lethal cocktails in the USA. The addition of morphine should improve the overall effectiveness of these mixtures. In addition, where humane methods of killing are sought, the addition of morphine to a lethal cocktail would diminish pain and suffering during and immeditely after dosing.Contrablue (talk) 22:12, 28 November 2009 (UTC)

Google for a reference. Without that, it will sound strange - morphine would need to be given in a massive dose to cause immediate respiratory depression and death. JFW | T@lk 6 July 2005 15:38 (UTC)

Considering this letter in BMJ (http://www.bmj.com/cgi/content/full/334/7591/440-c) that seems unlikely. --206.194.127.112 (talk) 20:20, 15 May 2008 (UTC)

Is there an LD-50 for morphine? If so, why is it not here? In a Tom Clancy book (Rainbow Six), clancy writes that pateints in pain can be given more than the lethal dose and suffer no ill effects, as long as they are in sufficeint pain. Is this true? --2tothe4 22:12, 13 August 2005 (UTC)

I know from first hand experience that even though I am opioid tolerant, I recently had a bout with extreme pain, and I was able to handle an amount of heroin that would normally floor me, so I believe this is true. Plus the pain makes you more alert. -Azrayl PS Can some one tell me how to add a timestamp?

There isn't a definitive LD₅₀ for morphine, because the lethal dose depends on the patient. The lethal dose in an opioid-naïve patient is much lower than for a person who has developed pharmacological tolerance to opioids. Therefore, it is true that morphine doses can be escalated, in certain patients, beyond what might be considered a "lethal" dose. -Techelf 12:49, 14 August 2005 (UTC)

The LD-50 is a dose that will, on average, kill 50% of the people who take it. So it's certainly true that roughly half the population can take more than the LD-50 and survive. (You probably already knew that, but I thought I'd clarify)--Superluser 20:28, 17 October 2006 (UTC)

Movingturtle 11:52, 27 September 2006 (UTC)

My impression was that LD50 numbers generally only exist for lab animals. How would you come up with a human LD50 figure for a drug? Obviously direct experimentation would be criminal, and people who die from overdoses generally won't have taken a known amount of the pure substance unless it was administered in a medical setting. Those receiving it medically won't be a representative sample of the general population for a number of reasons.--Eloil 10:40, 26 April 2007 (UTC)

Can someone add rectal to administration section —Preceding unsigned comment added by Dnaenterprises1 (talk • contribs) 11:58, 19 June 2008 (UTC)

can be produced, or is produced?

"According to recent research, it is also be produced naturally by the human brain."

As is above, the sentence is wrong. Is it can be produced or is produced? Gakrivas 09:43, 29 September 2005 (UTC)

I'd also dispute the correctness of the fact. The brain does not produce morphine but DOES produce neurotransmitters called opiods that act in the same places as morphine. User:Movingturtle

Morphine IS produced in the human brain, there are other entheogenic opioids in the body but they have found that small traces of morphine itself are produced and not from outside sources. Look for yourself. http://www.pnas.org/cgi/content/abstract/0405430101v1?view=abstract --Five- 19:56, 7 December 2006 (UTC)

More studies:

• http://www.pnas.org/cgi/content/abstract/102/24/8495
• http://www.jimmunol.org/cgi/content/abstract/175/11/7357

From the second: "Human plasma contains low, but physiologically significant, concentrations of morphine that can increase following trauma or exercise. We now demonstrate that normal, human white blood cells (WBC), specifically polymorphonuclear cells, contain and have the ability to synthesize morphine."

I think endogenous morphine in the human body is notable enough to be worthy of mention in the lead paragraph.--Eloil 10:54, 26 April 2007 (UTC)

On July 15th, 2009 I deleted the sentence stating that morphine is an endogenous substance (in the first paragraph). However, in light of the evidence kindly supplied by Five, I suggest making a new section that summarizes the findings of Poeaknapo group, Stefano group, and Zhou groups, along with the negative findings of the Boettcher group. Otherwise, it is my opinion that if we just made a blatant sentence in the introduction about morphine’s endogenous synthesis, it might be misleading to the lay readers. In that section it should also be stated that at least three of the labs used neuroblastoma cells, whose DNA is already screwed up, so results are a little bit open for interpretation. Nevertheless, I agree that whether or not morphine is synthesized in the human body is of general interest and, as such, it should be addressed in a separate section of the article. --Elenaschifirnet (talk) 18:53, 15 August 2009 (UTC)

What you are calling endogenous morphine are the endorphines or similar neuropetides.The human body does not produce morphine per se. When I encountered these entries, I was shocked. I deleted the sentence, "the human body produces morphine" a month ago because it is an incorrect statement. I mean there is the possibility that traces of morphine are indeed produced naturally by the human body but there are no confirmed findings of this. I then introduced the sentence that "the human body produces endorphines" which are among other neuropeptides, endogenous substances but not chemically related to morphine. These neuropeptides are the body's own morphine, but morphine itself is normally not produced by the human body otherwise nobody would pass a drug test! Other statements such as "morphine occurs in mulberry and certain hop varietes" are also unfounded. At least there is no confirmation of the occurence of any alkaloids in hops. Some part of the entries for "morphine" were terrible and written by people who do not know the basics. Again, there are no confirmed findings that the human body itself would produce significant amounts of morphine or related alkaloids. If someone would like to disagree, then please add a formally correct reference to a peer-reviewed journal! Five and others did not understand Zenk's paper. He introduced a new biochemical into the human body and then observed if morphine can be produced. But that does not prove that morphine is produced by the human body under normal conditions. You guys do not read the article right. Again, of course, we can introduce a precursor or related substance to any organism and something else is produced from it, but that proves nothing. Osterluzei (talk) 19:39, 6 February 2011 (UTC)

I have looked at this paper from Zenk again, and you guys are right (!sigh), they really were able to detect 10nM of morphine in human neuroblastoma cells. But that proves nothing, absolutely nothing. I have not seen reliable papers that would prove the presence of opiate alkaloids in the human body without dietary or environmental contribution. Also, when then such facts appear on wikipedia, we would start to believe something that is not true. With regard to opioid effects, these larger peptides seem to be the morphine equivalents not morphine itself. These concentrations are so low that these molecules could have come from anywhere. We are nowerdays able to detect pharmacological substances down to the picogram levels in human fluids for example in forensics (hence from the human body as a whole) and there is to my knowledge no evidence that a healthy human would produce endogenous morphine in form of these akaloids, and indeed such effects are caused by neuropeptides that bind to the opiate receptor. Morphine and analogs are agents that mimic the binding of such endogenous peptides, and the receptor was originally favoured due to these large biomolecules. On a physiological, there is no evidence that the human body produces these alkaloids in amounts signficant to cause an effect. If we are looking for certain molecules in biological materials these days, it seems, almost everything is in everything. Drugs in surface waters are reality for example. The question shall be more at what level these xenobiotics cause an effect. The papers used precursors for such morphine biosynthesis and it proves what we already know namely that biochemical process can change and modify subtstances. Also, compare the activity of these alkaloids with the affinity of the endorphines and enkephalines to the opiate receptor. As far as I know, they exceed their affinity many times.

The second paper too used a cell culture with the respective precursors. A culture of white blood cells. How should we understand this new science that uses a petri dish with cultured cells to interpret human physiology? To me, it comes as no surprise, that we arrive at wrong conclusions. What has been proven is that human cells seems to posses enzyme systems to synthesize morphine-like alkaloids or morphine itself if we supply the precursors for such in a cell culture. Maybe someday, we will find a biotechnological method to produce such drugs but the molecules of paramount importance, at least with regard to pain regulation, shall be the neuropeptides. —Preceding unsigned comment added by 62.203.50.249 (talk) 13:45, 20 February 2011 (UTC)

Endogenous morphine in mammals is a reality and I don't think this article does it justice. Morphine has been shown to be synthesized from oxygen-18 and marked precursors (tyramine, reticuline, ...) by human neuroblastomas, is found in human blood, CSF, urine, as well as mouse striatum, cortex, cerebellum, etc... Morphine-like immunoreactivity (meaning morphine, codeine, M3G and/or M6G) has been found in GABAergic neurons of the striatum as well as in astrocytes. There are high levels of morphine/codeine/tetrahydropapaveroline in PD patients receiving L-Dopa treatment. Mice without tyrosine hydroxylase do not have any endogenous morphine, as opposed to WT ones. Etc... See for review : http://www.ncbi.nlm.nih.gov/pubmed/2326654982.231.37.66 (talk) 00:54, 27 November 2014 (UTC)

2 year old daughter

My daughter recieved 7mg of morphine when she was supposed to recieve .7mg. There were no immediate side effects. Are there any long term effects that can arise?

Not really. The risks are associated with the immediate effects. Immediate risks are respiratory depression (slow or absent breathing) and coma (which predisposes to aspiration pneumonia). Provided these do not occur any long-term harm is very unlikely. JFW | T@lk 20:01, 30 January 2006 (UTC)

You need to look for deep depression and lone less, I was shot with morphine when I was about 5 years old, I know now, I did not know then. After more than 40 years, I was shot with morphine once more at an emergency room; I can now recapitulate my childhood. Look for her and make sure she is ok. —Preceding unsigned comment added by 70.179.46.149 (talk) 03:13, 14 May 2010 (UTC)

Discovery and isolation

In the History section dates for isolation and discovery need proper research and references. A cursory glance at Google results shows theredsiopfajdspofiasdiopfpodsiuoyoiuyiouyioyoiuyuiyuiyuiyuyuyuyuiyuiy are discrepancies in dates and the inventor. Kpjas 08:26, 22 February 2006 (UTC) fuk u faggets —Preceding unsigned comment added by 209.66.200.40 (talk) 15:49, 18 October 2010 (UTC)

morphine replacement

Could it be theoretically possible to synthesize a compound that is 100 times stronger than morphine and not addictive? Specifically at the receptor level? Filly

The first part of your question is possible (and already done), but probably not the second. Fentanyl is a synthetic opioid approximately 100-times the potency of morphine. Unfortunately, current understanding of opioid-receptor pharmacology is that μ-opioid receptor activation, responsible for most of the analgesia, is also associated with the dependence-liability of opioids. -Techelf 08:07, 28 February 2006 (UTC)

There is a way to use opioids and avoid addiction according to a few studies, using small doses of opioid/NMDA antagonists in conjunction with the opioid agonist. Magnesium has also been shown to prevent tolerance and psychological addiction to opioids.(as well as other drugs) --Five- 9:57 9 December 2006 (UTC)

Erm... disambigious link?

The disambigious link to Morphia, a dutch band seems non-related to me, anyone in favor? —The preceding unsigned comment was added by 213.89.140.71 (talk • contribs) .

The study in switzerland saying morphine is stronger than heroin

"In a randomised double-blind study with crossover at an outpatient clinic in Bern, Switzerland, morphine was proven to have stronger effects than heroin at equianalgesic doses. Respiratory depression, miosis, sedation, itchiness, and euphoria were more pronounced with morphine." --Azrayl 09:12, 15 July 2006 (UTC)

This is just plain wrong. If anything the study probably proved the exact opposite. Anyone versed in opiates knows that diacetylmorphine has more euphoria than morphine. If the opposite was true morphine would be more sought after than heroin, and people would not conver morphine sulphate pills to morphine hcl, then diamoprhine hcl using a home-bake process, as commonly found in the netherlands. Unless several sjhfgkj'lfdi'ljources can be found to validate that morphine is stronger than heroin (ridiculous) then I am going to remove this. --Azrayl 09:12, 15 July 2006 (UTC)

UPDATE: okay after reading the quote several times I realize it should say "stronger side-effects" rather than "stronger effects" and this is why I got confused as to why it was in there. I will put it back with the changed "side-effects" --Azrayl 09:12, 15 July 2006 (UTC)

Actually, I have read that study and I can safely say that it did indeed say that morphines effects were stronger at equanalgesic doses. I have to say that I myself was surpised as I have always thought morphine is second fiddle to heroin among the opiates. Now, after reading it a few times, I realized the key words and they were EQUANALGESIC DOSE (which basically translates to doses of morphine and heroin that would bring about equal pain relief, but morphines effects were more intense in doing so - this in turn translates to "heroin being safer as there is less incidence of respiratory depression, miosis, and euphoria")! This means about 10mg morphine IM and 5mg diamorphine IM. Granted, heroin is MORE POTENT, but the study seems to indicate (and they were adament) that morphine is more intense in it's effects. Unfortunately, I cannot seem to find the study report published by the scientists online (where I had originally read it). It was in a Medical Journal online and they seem to have taken it off. TheGoodSon 06:12, 19 July 2006 (UTC)

I strongly agree with Azray on this one that that particular article needs to be found. It may in fact be quite possible that that side effects of morphine are more pronounced, but euphoria is probably more likely to occur in heroin use, as diacetyl morphine has direct action on mu receptors, but then is also metabolised into morphine, which then in turn also activates mu receptors, and is then further metabolised. It is possible though, that heroin's effects are not any different than morphine, but just has a much faster onset. This may reduce the body's down-regulation process in regards to endorphin (the neurohormone morphine mimicks), which may cause fewer side effects, as the action potential takes place before the body can "fight it" so to speak. Of course, all of this is complete speculation without hard evidence. Please find that article. Thank you. iownutopia 21 July 06

Well if you think about it, heroin is only just a pro-drug, meaning it exists only in the external form. Heroin is actually converted into morphine (almost 100% of it) and morphine is the molecule which causes all the side-effects of heroin. The only difference, as mentioned above, is that heroin has a quicker onset of effects. Think about it like this: heroin is a boat carrying morphine to it's destination because morphine would take longer to get there by just swimming. This is really just what i;l

fdaskslkgf;lkjgdsf;jkgfdpokgt is. The two drugs are exchangeable. Also I should mention that POTENCY does not automatically mean "stronger". Oxycodone and hydromorphone are "more potent" than morphine, but morphine has a higher liability to be abused and is much more intense in it's effects. So I am no longer surprised that morphine maybe more intense than heroin is - it's just that heroin has been all over the place and in peoples minds, it's on the news all the time, it gets more attention, it's more taboo, it's more chic, "cooler" and people just get shocked when they hear that heroin may not be what they thought it was (i think this is what happened here to myself at first, Azray and the rest)...you get my drift? It is LEGAL for prescription in the UK and some other countries. In fact, heroin is used much in the same way morphine is used in British hospitals - it is considered safer and I've heard from doctors who think it is a better alternative to morphine (which is well known and documented to cause morbid psychological conditions including a sense of "not being real", low self-esteem, sense that death is immenent, etc etc). There have been cases where people have literally become crazy from long term morphine use, especially terminally ill patients. Basically, morphine degrades the human soul and mind even in the medical setting, which heroin does not. TheGoodSon 22 July 2006 09:26am (UTC)

TheGoodSon writes "morphine degrades the human soul and mind even in the medical setting,"

Huh? There is no basis for that claim. Sure there have been cases where people on long term morphine use have become "crazy." People on long-term apple use have become crazy too, not to mention people on long-term use of figs. There is no basis for thinking that morphine "degrades" the human soul or mind, whatever on earth "degrades" is supposed to mean, anyway. It has more pejorative connotation than any sort of denotation. It means little more than the existance of people on morphine doesn't meet with your approval.

TheGoodSon- I assume you are not a doctor, because your medical knowlege is woeful. After an operation most people are grateful for morphine's pain relieving properties, and it is fine to use providing it is not abused and used for more than a short term analgesic. Are you a heroin user by any chance? I have noticed you also added a lengthy article to the Withdrawal section about how addicts constantly think about morphine, and that withdrawal sysmptoms last for life- all unsourced and doubtful. Hence it has been removed, as I refuse to take the comments of somebody who says "morphine degrades the human soul and mind even in the medical setting" seriously........you obviously have an agenda which shouldn't be acted out in the Article.

Diacetylmorphine immediately brakes down to morphine in the body. For example, most orally administred heroin is broken down to morphine in the intestines. The diacetyl- is just a transport form, it can be absorbed much better, e.g. in insufflation or injection and crosses the blood/brain barrier much quicker so that diacetlymorphine is a more bioavailable form of morphine. The half-life or heroin ist just a few minutes. Read it up under the entry for diacetylmorphine. So, this discussion is silly if you do not know anything about pharmakokinetics.Osterluzei (talk) 20:08, 6 February 2011 (UTC)

For equal narcosis : 1 of diamorphine for 1.5 of morphine. With that doses, diamorphine is also 2 to 3 times more analgesic than morphine, but gives the same "morphinic feeling" (euphoria, congestion...). So diamorphine is 3 to 4.5 times more heroic (active) than morphine (heroic is a German term for "active", "medicinal"...). When we give 10mg of morphine, we give only 2.5 to 5mg of diamoprhine, so diamorphine will be felt less narcotic than morphine in an analgesic dose (the narcosis and the congestion correspond to 3.75 to 7.5mg of morphine only). But when it is used as a narcotic, diamorphine becomes 2 to 3 times more addictive than morphine. Someone who takes 30mg of morphine would take 20mg of heroin to feel the same, but his analgesia is 2 to 3 times more active with heroin, it is a stronger heroic than morphine (it goes deeper), just like morphine is a stronger heroic than codeine (or the 10% of morphine freed by codeine). In those 3 cases, morphine is not distributed in the same way and areas. Narcotic and withdrawals (global) : 200mg codeine= 30mg morphine= 20mg diamoprhine (it is the same correspondence for caught sedative doses, drying mucus and somewhat dopamine distribution, nausea and constipation). Analgesic (deep) and dependence : 200mg codeine= 7 to 10 mg morphine = 1.5 to 3mg diamorphine. Diamoprhine is much deeper than the others and can be used at lower doses for an equal result, so there is less withdrawals, narcosis, congestion, etc., in a medical use. It is the same for codeine, when 200mg would give very important withdrawals and insufficient results, we prefer morphine (much stronger). The difference between morphine and diamorphine is quiet the same. The risk is that it gives a deeper dependence when (mis)used as a narcotic...--82.216.67.105 (talk) 00:10, 2 March 2011 (UTC)

Morphine Pharmacology

The morphine pharmacology has been changed from what I originally put to say specific receptors were associated with various effects opposed to thought to be responsible for their effects. It is not proven what receptors mediate what effects a hundred percent and this should be specified. Also, the mu receptor is abbereviated while kappa receptor is not. The whole pharmacology section should be expanded on and not so simple and general.

Does anyone know whether Morphine acts on 5-HT3 receptors? I have come across a few papers that seem to imply that, but I could not find a definite answer.. —Preceding unsigned comment added by 129.215.25.20 (talk) 14:18, 11 December 2008 (UTC)

At first I noticed that it was Gaddum who proposed that Morphine antagonised 5-HT receptors in his paper "Two kinds of Tryptamine Receptor" in 1957, but I wouldn't trust that, since they also thought that LSD was antagonist to 5-HT when in fact it is an agonist with lower efficacy but higher affinity than 5-HT. Another paper I found written in 2006 seems to suggest that morphine might be a competitive antagonist to 5-HT3 (http://www.anesthanalg.net/cgi/content/abstract/103/3/747). Please could anyone who know about it more than I do confirm this? (Or say why this is not the case). --Ev129.215.25.20 (talk) 21:04, 11 December 2008 (UTC)

legally where?

The article has the phrase "Morphine is used legally" without a statement of where these uses are legal. I wouldn't be surprised if some countries (e.g. Afghanistan) have no laws restricting the use of morphine. I propose that this be changed to describe where these uses are legal. I don't know the laws in every country, or else I'd do it myself. --Superluser 20:21, 17 October 2006 (UTC)

Morphine is used legally in hospitals, dumbass :p

In every country? For all of the reasons listed? I'd bet that you could find at least one country where at least one of those uses is not legal. The point is that this section is too general, and should include some specificity. superluser_tc 2007 July 16, 22:06 (UTC)

Well, there are no laws in Somalia, so I guess it's legal there. There are plenty of places where enforcement of laws is so innefective so that it's almost defacto legal. I can't really think of any nation that actually, deliberfdpohkgfophkifgately allows morphine to be used for only recreational purposes, however, and if there are finding such a list would be somewhat of a task. Watermark0n 21:47, 20 July 2007 (UTC)

Morphine Pharmacology

This part really needs fixed. It currently is a few random facts and a little misinformation, over-generalizations, etc.

The same anonymous user to leave the above line left some similar complaints in the article itself. I have removed them. I know nothing about morphine so I don't know if any further changes to the article are needed or appropriate, but I do know there is a right and a wrong way to go about requesting changes to an article. I would suggest that the anonymous user who feels that changes need to be made should actually make those changes himself. If he knows enough to see that the information is incorrect, he should know enough to improve it. --Suttkus 14:47, 29 November 2006 (UTC)

Okay, I have made a few changes but somebody who knows more about neuropharmacology needs to work on it, I know enough to say that some of it is misleading or just incorrect. I will continue to keep making it better. If I made a change someone doesn't agree with, please just revert that one part, I added a lot of correct information. Feel free to reword any of it as long as it remains accurate. Also if something I put doesn't sound right just ask in here and I will put sources. --Five- 23:35 7 December 2006 (UTC)

Your edits look very good, Five. Please feel free to continue making any corrections or alterations you feel are necessary. I know anyone who disagrees with your edits won't hesitate to let you know! Welcome to the 'pedia. :) Sarah Ewart 10:23, 8 December 2006 (UTC)

Oops, glad someone fixed that, I put the wrong enzyme --Five-

weird question

I'm currently dating a cancer patient who iskhlgdg;lg receiving morphine. I've heard that it can be trapped in sperm and released through oral intercourse, with the recipient recieving similar benifits from the morphine...is this true? —The preceding unsigned comment was added by 12.207.160.238 (talk) 05:43, 10 May 2007 (UTC).

I'd very much doubt it, but I could be wrong, I guess. Exigence 17:12, 6 June 2007 (UTC)

Even if this was a biological possibility (which I don't think it is), the amount of bioavailable morphine would be negligible. The only way I can imagine it happening (and it requires quite a leap of imagination) is if it was introduced as some sort of casomorphin. In which case, it's potential effect on another human would again be negligible.K10wnsta (talk) 09:14, 12 November 2008 (UTC)

Morphine sold as heroin

Is morphine ever passed off as heroin?

I'm sure it's happened. People have passed off flour, sand and any number of other things as it. 83.147.180.185 20:01, 28 August 2007 (UTC)

Yes, sometimes. When it's not cooked to convert the morphine to heroin, or if it's from morphine tablets crushed and cut with a bulking agent. —Preceding unsigned comment added by Dnaenterprises1 (talk • contribs) 11:57, 19 June 2008 (UTC)

Note HOWEVER; heroin completely metabolizes in your system into morphine within 6 hours. So 6 hours after taking a drug test if you screen clean for 6-acetylmorphine (the metabolite to check if you've taken heroin specifically) but test positive for morphine, it still does not determine whether you are taking heroin or not, because a true pure and full heroin dose would become completely morphine in your system by then anyhow. 4.242.174.52 (talk) 13:36, 17 October 2009 (UTC)

Opiates

These replace the psycho-chemical version of pleasure. It is no more complicated.

It's much more complicated than that. Alcohol, marijuana and cocaine for example all induce "pleasure" in users, but none of these drugs act on opioid receptors in the brain. Pleasure is a complicated and subjective thing and no one areea of the brain completely dictates your mood. 83.147.180.185 20:04, 28 August 2007 (UTC)

why and how do you get off morphene without any major side affects —Preceding unsigned comment added by 65.31.148.171 (talk) 04:01, 4 November 2009 (UTC)

Bioavailability

This article says that the bioavailability is around 30%, but I'm pretty sure that it is lower than that. What is this citing? Who ever said the bioavailability (I'm assuming this is oral) was around 30%?

Alright, I'm just going to change it to ~15%, because that's what the conversion guide on a box of fentanyl patches says....

Bioavailability 25%: From J. Cannon, Pharmacology for Chemists, pg. 179-- Ashujo September 5, 2007 —Preceding unsigned comment added by Ashujo (talk • contribs) 22:19, 5 September 2007 (UTC)

Comparing with Fentanyl

Fentanyl is an opioid analgesic, first synthesized by Janssen Pharmaceutica (Belgium) in the late 1950s, with an analgesic potency of about 80 times that of morphine.

source: http://en.wikipedia.org/wiki/Fentanyl

Studies done on the efficacy of various opioids have indicated that, in the management of severe pain, no other narcotic analgesic is more effective or superior to morphine.

source: http://en.wikipedia.org/wiki/Morphine

And, what should be your point? It's perfectly compatible. Analgesic potency is only an approximate index given to obtain similar analgesic effect in terms of dose. It doesn't say anything about the quality of the overall therapeutic effect achieved. The second statment just means, that no other opioid ("narcotic analgesic") was found to be superior to morphine in the treatment of severe pain. Meaning, that while 0.2 mg fentanyl can have similar analgesic potency to 15 - 20 mg morphine, the analgesic effect of fentanyl is not qualitatively superior, or better than that of morphine. Hope it's clear.--84.163.127.69 10:38, 3 November 2007 (UTC)

Street/Slang Names

I've removed the following list. It's all unreferenced, and is basically listcruft. Perhaps someone might like to pull out the most commonly-used three or so names and add a mention of them to the article? Kla’quot (talk | contribs) 07:44, 11 September 2007 (UTC)

M M.S. Miss Emma Dreamer Hospital Heroin Blue Velvet -- with tripelennamine Gunk Contin Dope Morf khflgsosfGerman boy Emsel Monkey Cfdg;lkdsfgotton Brothers -- refers to cocaine, morphine and heroin

Whiz-bang -- combination of cocaine/heroin OR cocaine/morphine White stuff Hardcore Hard stuff C&M -- cocaine and morphine New Jack Swing -- heroin and morphine Morphia First line God's Drug Hows Mister Blue Adolf Unkie Coco Pop (For Co-codamol) Fiend More

addiction info appears incorrect

i cut out the following text because i believe it to be wrong or misleading.

Compared to other narcotic pain relievers, such as codeine, hydrocodone, and oxycodone, morphine is considerably more liable for abuse and dependence. More potent narcotics, such as hydromorphone and fentanyl, have high abuse potential, but still less than that of morphine. Only heroin, which is nearly identical to morphine, is comparable in dependence liability. Physical dependence and withdrawal symptoms can appear after only five days of administration. In a Japanese study, mice, which received morphine (10 mg kg-1 s.c.) twice a day for 5 days showed withdrawal syndromes such as jumping, rearing and forepaw tremor following naloxone challenge (5 mg kg-1 i.p.) on the 6th day. Such mice exhibited a significant elevation of cyclic AMP levels in the thalamus compared to control mice. Brown University Professor Julie Kauer and colleagues found as little as a single dose of morphine could contribute to addiction. A single dose of morphine can block a process in the brain associated with learning and memory for as long as a full day after being ingested. In a study, researchers found long-term potentiation, or LTP, is blocked in the brains of rats given as little as a single dose of morphine. The drug's impact was very powerful, with LTP continuing to be blocked 24 hours later -- long after the drug was out of the animal's system.

i don't believe that it is generally accepted that morphine has a higher abuse potential than other narcotics. i do see a couple of studies quoted in the following paragraph that may suggest this, but (1) there's no way to verify the link; (2) you can find studies in favor of almost any point of view, regardlefvbgfds',gld,fslgss of whether the views are commonly accepted.

this paragraph also tries to expound the "one dose can get you hooked" theory, which is definitely not generally accepted; and the info about japanese mice is hard to interpret and of questionable relevance. Benwing 03:47, 18 September 2007 (UTC)

I think you've made a good call. So far what I've read says that the potential for abuse is way overblown, e.g. [1]. Whatever good information there is in what you've cut needs to be put into more context. Kla’quot (talk | contribs) 04:04, 18 September 2007 (UTC)

Now that I'm looking at the remaining paragraph (section 5.1 "addiction"), I think it's highly flawed and really should be removed. There's already stuff a few paragraphs below about addiction (which also appears flawed, but perhaps not so badly), and this paragraph shows total confusion between physical and psychological dependence, and both of the studies it quotes are more than 40 years old. The second paragraph of the lower section (section 5.2 "withdrawal syndrome") also contains some rather questionable assertions, based on dubious sources -- e.g. one of them is from the US DOJ (unlikely to be a neutral source) and another is based on rat studies, but is used to make claims about humans. I don't have time to fix it but I hope someone else does; meanwhile, I've tagged the info as disputed. Benwing 03:24, 19 September 2007 (UTC)

medicine

this medicine is iatrogenic

How long will it take to get out of your system ?

If you accidentally took an extended form of the drug by mistake, how long will it take to be completely out of your system ? I took one of my moms, misstaking it for one of my perscription IB proffen. and failed two UA's in one month costing me two great jobs!

Know one will ever believe you when you say it was a accident, even with a perfect record, no tickets no nothing !

Morphine will only cause a failed UA test for 3-4 days. I assume that you took two tests within the first week of the month. If not, the drug tests produced false positives, you eat 20 poppy-seed bagels a day, or you forgot to mention you shoot 2 bags of heroin a day. —Preceding unsigned comment added by 76.178.247.59 (talk) 21:52, 1 February 2009 (UTC)

                                                 75.164.187.59 (talk) 05:34, 15 March 2008 (UTC)Trevor

Morphine effects on immune system section

This section is very nice, but REALLY needs references, particularly because it cites specific papers from scientific literature. (They would have been very useful to me personally, too.) Mlbish (talk) 18:33, 4 April 2008 (UTC)

IL-10 it's a pleoitropic cytokine whose main function it's anti-inflamatory (it even says so in the article's link to IL-10), as for example downregulating T cell proliferation. I've never heard (or read) about it's function on B cells though I might be wrong. ´´´´´´´´´´´´´Dayenu (talk) 02:57, 4 June 2008 (UTC)

Referencens not correct

Am I the only one who noted, that references 22, 23 and 24 are the same? Given they are used to backup one particular (questionable) thesis, I don't think it's correct to do it this way.--84.163.108.227 (talk) 23:07, 22 April 2008 (UTC)

Nice catch! #19 was the same too, and the paragraph for 22-24 was largely plagiarized from the abstract of the paper in question. I consolidated references and summarized the study (the plagiarist left out one of the main findings - 5 of the 8 addicts preferred heroin after multiple injections despite their very similar subjective ratings). Some more recent references on the matter would improve the section dramatically. St3vo (talk) 01:29, 23 April 2008 (UTC)

Morphine Rejection

About four years ago, I had my gall bladder taken out because of ridiculous amounts of gall stones. After placing me in as an inpatient, they quickly put me on a morphine drip. Oddly enough, I was still in extreme pain. I mentioned this to my doctor, and he switched me to a demerol drip (which worked very, very well). For the life of me, I can't remember what he told me as to why my body wasn't phased by morphine. I've tried researching it, but I can't find anything. When I mention through medical conversations with people that morphine doesn't do anything to me, they don't believe me. I was wondering if anyone knew what this is called, or if there are any medical terms or reasonings behind it. 70.160.220.179 (talk) 03:18, 16 September 2008 (UTC)

Sometimes, pethidine (Demerol in the US) is better working short-term for "visceral" pain with smooth muscle spasticity, in some patients. For most, the pain is adequately alleviated by morphine with an antispasmodic, though.--84.163.113.35 (talk) 04:01, 21 November 2008 (UTC)

Demerol does not affect the sphincter of eddi, morphine does, that would ADD pain. —Preceding unsigned comment added by 79.64.153.205 (talk) 10:00, 23 February 2010 (UTC)

Same with me. I was in for gallstones and the morphine barely helped but when they switched me to something called dilaudin that did the trick. 66.160.226.249 (talk) 17:19, 30 April 2011 (UTC)

Clarification on : Morphine withdrawal is considered less dangerous than alcohol, barbiturate, or benzodiazepine withdrawal.[28]

In citation reference # 28, "DEA Briefs & Background, Drugs and Drug Abuse, Drug Descriptions, Narcotics"(http://www.usdoj.gov/dea/concern/narcotics.html), we could not find the said statement.Kindly clarify how the statement was taken, and correct the statement after verification, if any. —Preceding unsigned comment added by Salamath (talk • contribs) 07:08, 9 October 2008 (UTC) This is common knowledge. Morphine withdrawal is never directly fatal. Any fatalities related to morphine withdrawal would be related to a pre-existing condition, (i.e. seizure disorder, hypotension, etc.) Barbituates, alcohol, and notably benzodiazapine medication can, and often do cause seizures when chronic high dose use is abruptly terminated. Seizures are the cheif hazard with these three CNS depressants in acute withdrawal. Not the case with opiates.--FeliksD (talk) 04:47, 18 October 2009 (UTC)

Truth. Ironically, its well known to law enforcement. its how a good 20-30%, possibly more, of the regional law enforcement/government chosen policy towards inmates in jails who are also addicted to opiates is to deny them access to methadone or buprenorphine, and often highly restrictive of legitimate prescriptions. IF there was even a small concern that opiate withdrawal was intrinsically dangerous to anyone in general, then there would not be such policies on the books anywhere due to the liability. However, Opiate withdrwal IS non-life threatening, and one of the important stages of prisoner intake is to identify addicts, and to identify those addicts that possess preexisting medical conditions that CREATE a risk due to withdrawal (create because no risk exists otherwise).... Healthy addicts, on the other hand, are completely ignored while they screen and yell, pace, frantically stretch every muscle they can, etc. Its a very very common policy in California county governments.184.189.220.114 (talk) 02:31, 14 May 2013 (UTC)

Chemical name synonym finder brings up a different chemical as "morphine"

What is this chemical listed as "Morphine"? It is the only thing that comes up when "morphine" is entered at this site. It has a different CAS #, a different IUPAC name & a different chemical formula than morphine. N,N-diethyl-N'-(2-methoxyacridin-9-yl)pentane-1,4-diamine CAS: 23552-18-3 Forumla: C23H31N3O Nagelfar (talk) 16:48, 17 November 2008 (UTC)

Who knows why they've labelled that as morphine. All I know is you can't always trust that site to put the correct name and structure together.

The structures given in this (Wikipedia) article are referenced to peer-reviewed academic papers.

Ben (talk) 16:53, 17 November 2008 (UTC)

Strange indeed, I have never heard of another chemical known as 'morphine', but I would't advocate it's inclusion into the article about the opiate.--Metalhead94 ^{T C} 16:30, 27 November 2008 (UTC)

Does Morphine kill sperm cells 24 hours after the last dose?

A friend of mine had unprotected sex and the guy had been in the hospital the night before. His friend and him looked it up and told her that Morphine kills the sperm 24 hours after the last dose. Im not sure where they found it and i am not able to find anything on it and i wouldnt like to see my friend knocked up over a lie. —Preceding unsigned comment added by 71.213.167.96 (talk) 04:32, 9 December 2008 (UTC)

Sorry, but that is not true. The only thing that helps in such a case is emergency contraception, as soon as possible, but not later than 72 hours after sex. And even that does not help against infections with sexually transmitted diseases. --ἀνυπόδητος (talk) 10:12, 9 December 2008 (UTC)

Is this okay?

Some people with access to relatively pure morphine from whatever source use various methods to turn it into heroin and, less frequently, other derivatives like hydromorphone or oxymorphone. These range from the home-bake labs of New Zealand which use codeine extracted from OTC or prescription preparations which is turned into morphine and then acetylated with acetic anhydride to a related method in which powder containing morphine salts or base is put in a spoon and wet with acetic anhydride at a proportion of 1 ml of acetic anhydride to 1 gramme of morphine content and the bowl of the spoon tightly covered with tin foil and baked in an oven at a temperature around 80°C but not above 85°C for 1 to 5 hours and reheated on the stove over low heat if needed until the mixture is dry and no longer emits the characteristic noxious fumes of acetic anhydride. The result of these processes is often a mixture of morphine, heroin, 3-monoacetylmorphine, and 6-monoacetymorphine in varying proportions.

It seems like it's giving instructions on how to make heroin...

64.126.94.10 (talk) 06:52, 25 December 2008 (UTC)

This information is readily availiable, and anyone that could/would convert morphine to heroin isnt getting their information from wikipedia. Having said that this is a bit like a how to guide, and written in poor style. I have edited it.

Tpepper88 (talk) 20:05, 1 January 2009 (UTC)

Side Effects table

What do you guys think to the side effects table present in this article. I find it is messy and distracting and do not like the format of it at all, but don't want to delete because someone obviously spent sometime compiling that. Is there anyway we can reformat it to make it more readable? Or another way to list the side effects not in the table? All Opinions welcome. Tpepper88 (talk) 20:10, 1 January 2009 (UTC)

Salt Table

DO you guys think that the table that lists all the different salts of morphine is within the scope of this article? I dont think any general audience, or even most of the scientific audience reading this article is going to have any use for it. It also takes up alot of space and is unrelated to any text presented in the article. What do you guys think about getting rid of it? Tpepper88 (talk) 20:10, 1 January 2009 (UTC) I agree, get rid of it. Only one is used in the pharm. industry. Rest is chemistry related. --FeliksD (talk) 04:42, 18 October 2009 (UTC)

MS-Contin

This article forwards here, but there is virtually no mention of the extended release nature of this drug. I think it should be mentioned more than in passing. 152.133.7.130 (talk) 19:28, 8 April 2009 (UTC)

The "Contin" in MS Contin, as like the brand name OxyContin, stands for Continuous Release, CR, the same as XR/ER for extended release. MS Contin is simply Morphine Sulfate Continuous (release). The brand name itself implies it. Being the plethora of brand names (not to mention the multitude of generic names, which are however at least of more informational pertinence, seeing too how brand names number many more) and the fact that the brand name is very straight-forward as to what the product is (unlike very many others), mentioning it in passing is enough just in that MS Contin is such a notably popular brand name of morphine in the U.S. (if you are trying to distinguish why its has not the mode of action as immediate release forms, the fact that it is sulfate and not a hydrochloride adds to that fact just as much as the pill binder extended release). Nagelfar (talk) 14:48, 4 August 2010 (UTC)

Area postrema

That article says that morphine directly stimulates the area postrema and causes vomiting, but vomiting isn't listed as a side effect here, except as part of withdrawal. Which article is wrong (or misleading)? 81.131.66.245 (talk) 14:58, 2 June 2009 (UTC) In many non-tolerant individuals, nausea and or vomiting is a potential side effecy of opioid therapy. It is common in an ER setting when IV opiates are administered, an antiemetic (anti-nausea/ vomiting drug) is given simultaneously to avoid this side effect. Tolerance to nausea and vomiting occurs rapidly among chronic users... --FeliksD (talk) 04:40, 18 October 2009 (UTC)

ms contin vs oxycontin

how does a 60mg ms contin compare to oxycontin? —Preceding unsigned comment added by 74.244.117.134 (talk) 01:51, 29 August 2009 (UTC)

Oral bio-availability of morphine is poor compared to oxycodone/-contin. (which is why morphine is often made into a pro-drug; e.g. acetylated; i.e. made into heroin.) Morphine has much more binder-filler due to potential abuse. If you are asking oxycontin in particular (binder filled extended release and not the oxycodone chemical itself in comparison), I'd say it is a bit more than 50% more required to make it equal, we are talking about two HCl salt versions in ER (extended release) formats. I would have to say, purely from personal experience and a non-professions / laymans one at that; that you need twice MSContin to get the effect of oxycontin, rather than only half again as much. But DO NOT take that as proper medical advice. Thank you and be safe and do not get addicted to pain killers. 4.242.174.52 (talk) 13:20, 17 October 2009 (UTC)

In my ever so humble opinion, this is not the forum for discussing abuse potential of a narcotic medicine. That being said, According to CMDT manual, and various other equianalgesic dosing tables, 90-120 MS Contin is equivalent to 40mg Oxycodone ER (Oxycontin,) assuming a q. 12 hr dosing schedule. —Preceding unsigned comment added by FeliksD (talk • contribs) 23:40, 17 October 2009 (UTC)

I would like to argue that this topic does not necessarily pertain to abuse. I suffer from severe chronic pain and endorphin deficiency. As a result (though much more the former than the latter) I have been taking legally prescribed opioids since I was in my late teens (I am now almost 30.) My first doctor began treating me with Vicodin and then Lortab, but when it became clear that my pain was chronic, she put me on OxyContin, on which I remained for many years at a steady dose of three 80mg tablets per day. After several years at that dosage I briefly went up to four 80mg pills a day, but was forced to return to the three-a-day dosage by my insurance company at the time refusing to pay for the higher prescription. So three 80s a day became my life. Then when Purdue changed the formulation and OCs stopped existing, I found to my horror that the new formulation, the OPs, do not work for me at all. They caused extremely distressing effects which suggested, to me anyway, that the amount of drug in each pill was very inconsistent. Sometimes I would feel "high" when I had taken only my normal dose. Other times I would take a dose and end up getting sick with withdrawal as if I'd taken nothing at all. Still other times I would get pain relief but I would have horrible side effects similar to withdrawal anyway -- vomiting, heat waves, and the like. As a result I was forced to stop taking OxyContin. My current doctor switched me to MSContin instead. My new dose was TWO 60mg tablets three times per day. In short, I went from taking 240mgs of oxycodone per day to taking 360mgs of morphine per day. Even this, while adequate to keep me from going into withdrawal, proved unable to control my pain, such that I was recently put on a six-hour schedule instead of an eight-hour schedule... meaning EIGHT 60s a day. Meaning, to get equivalent pain relief as when I was taking 240mg of oxycodone, I ended up needing 480mg of oral morphine. 480mg of morphine versus 240mg of oxycodone. So, for those interested in such data, there's a case study for you, if not a terribly objective one thanks to its self-reported nature. I did my best. :p (And BTW, I want my OCs back, Purdue! I'd much rather take three pills a day than eight, thank you!) 75.18.179.81 (talk) 13:15, 30 August 2012 (UTC)

This is not a forum for disccusion, please go to opiophile, bluelight.ru, drugs-forum.org, etc., you'll get good answers there about opiates (recreational or medical.) By the way, there is no such thing as endorphin deficiency that is recognized by the medical profession. To be honest people who talk about EDS are usually rationalizing their opiate usage. C6541 (T↔C) 20:14, 30 August 2012 (UTC)

I was commenting on the question of equivalency and conversion, which seemed to me to be the topic at hand on this section of the page. It was an attempt to provide data, to wit that you need about 2mg of morphine to equal the effect of 1mg of oxycodone. Others answered the same question, providing similar data, albeit in a different manner, with no challenge offered. Is it merely that I chose to illustrate my point using personal examples that makes it somehow unacceptable? That seems irrational to me. And as far as the endorphin deficiency thing goes, your comment about 'rationalizing their opiate use' reveals your bias. As a legal chronic pain patient I have absolutely no need whatsoever to "rationalize" my opiate use. I have never been a street user and I have never misused my medication. In fact I never made any connection between my pain medicine and the improvement in my mental health since beginning it until my own doctor pointed it out. So I suppose you'll simply have to disagree with him. No offense, but I trust my own doctor over you. :) 75.18.179.81 (talk) 14:51, 31 August 2012 (UTC)

Oh, and by the way, your statement that there is no medically recognized concept of endorphin deficiency runs smack in the face of the latest research on alcoholism. Here is a single example from a single journal:

http://jcem.endojournals.org/content/55/3/583.short This paper seems to be arguing that alcoholism may be due to deficiency in beta endorphins. So... apparently, there's no medically recognized endorphin deficiency syndrome, yet there IS strong research connecting alcoholism to endorphin deficiency syndrome. How precisely is that possible, sir? Please explain. If you want more published peer-reviewed references to the concept I am glad to find and repost as many as you require. If I am misinterpreting something, I will be genuinely glad to be educated, but, while I am indeed a layman, I am an autodidact who thrives on learning and I have done my best to educate myself on my own. I am no expert, but I am also not totally ignorant on these subjects, so I expect any debunking of this concept to be not merely pejorative, but based on facts and logic. Otherwise you will be wasting your own time as much as mine. Thank you. 75.18.179.81 (talk) 15:02, 31 August 2012 (UTC)

You can have lower than normal levels of a chemical in your body, but that doesn't mean it is recognized as a distinct syndrome. I can't remember EDS being in my DSM. C6541 (T↔C) 00:47, 7 September 2012 (UTC)

Why would EDS be in your DSM? EDS is a physical disorder, not a psychological one. 96.54.73.161 (talk) 08:03, 20 March 2013 (UTC)

Human and other mammal cells produce morphine

There are many articles online about studies revealing that animals including human naturally produce a level of morphine. There are 2 links below. I think we should fit this into the article somehow.

http://www.the-scientist.com/article/display/22412/

http://pubs.acs.org/cen/news/8238/8238morphine.html

http://news.healingwell.com/index.php?p=news1&id=521292

Should this be added? Danno81 (talk) 08:07, 16 October 2009 (UTC)

Ok, there is, I just missed it!

"In 2003 there was discovery of endogenous morphine occurring naturally in the human body. Thirty years of speculation were made on this subject because there was a receptor that apparently only reacted to morphine, the mu3 opiate receptor in human tissue.[12] Human cells that form in reaction to cancerous neuroblastoma cells have been found to contain trace amounts of endogenous morphine.[13]"

I'll shut up now Danno81 (talk) 08:08, 16 October 2009 (UTC)

Huh. Interesting how brains think alike, the last part, about the neuroblastoma cells, was added just a few days before your inveighed that you believed that information was missing; I suppose there is a collective consciousness out there. 4.242.174.52 (talk) 13:43, 17 October 2009 (UTC)

Different morphine salts, more information?

The freebase conversion ratio is nice, but could we also get water solubility, lipid solubility, and BBB crossing bio-availability of each? 4.242.174.52 (talk) 13:22, 17 October 2009 (UTC)

For water solubility of particular salts, one can refer to the Merck Index, Pharmacopoeias and the like. Lipid solubilities (I assume you mean solubility of particular salt in oil/fat) are generaly low to virtualy none (except higher alkanoic acid salts, but even those are just marginaly better fat-soluble than more polar morphinium salts), and doesn't really matter in medical context. The blood-brain-barrier crossing and bio-availability are not affected by the anion coutnerpart in a salt of morphinium — even morphinium bond to a high-molecular catex resin (e.g. morphine resinate) has practicaly the same bioavailabilty (if given p.o., in terms of AUC) as readily water soluble salts in "immediate release" galenics (simple morphine sulfate tablets, oral solutions etc.); once systematicaly resorbed, the anion doesn't contribute to pharmacokinetics anymore, as for the crossing of the blood-brain-barrier and the like, it's all about the morphinium (N-protonated cation) — morphine (free base) equilibrium, lipid solubility of morphine as such and eventually passive or active carriers in the BBB. Cheers,--93.192.179.179 (talk) 00:29, 21 October 2009 (UTC)

Morphine/ APAP Combination Products?

- The "potential side effects" section includes possible liver damage due to APAP content. There is no Morphine/ APAP formulation currently marketed in the United States. - Concomitant use of other opiates/ opioids, and use of benzodiazapines is a relative contraindication. These medications are WIDELY prescribed as adjuvant medications for pain/ pain+ anxiety in the U.S. (i.e. "breakthrough medicine." This should be clarified.

--FeliksD (talk) 23:34, 17 October 2009 (UTC) heloo i am kjhfwbjkfhak hjwhwhK —Preceding unsigned comment added by 99.232.163.82 (talk) 23:15, 27 April 2011 (UTC)

History

Paracelsus, who fancied himself as a travelling doctor

Whatever one may think of his theories, Paracelsus actually was a physician. He testified that he had a doctorate from Ferrara, and no one seems to have challenged that. Although there is no proof either way, and he may not have possessed a doctoral degree, he was referred to and dealt with by others as a doctor.

His travels were not entirely voluntary. He was forced out of various medical marketplaces, because his ideas about medicine or religion were not acceptable to his competitors.

This article states that morphine was later found to be more addictive than alcohol or opium. I am just wondering how "addictive" is being measured. If it is by the dangerousness of the withdrawals, I would've thought that alcohol was much higher. This sound a bit like an assumption based on observation of people who are "addicted" within the context of one substance being legal and one illegal. —Preceding unsigned comment added by 123.243.114.41 (talk) 09:17, 8 March 2010 (UTC)

76.208.32.9 (talk) 17:00, 28 October 2009 (UTC) David Harley

Use of the word poison

This is a small thing but I will ask anyways. In the article it uses the sentence: The latter is an antidote to reverse the effect of the poison. I think technically you could label morphine as a poison but it doesn't seem necessary. An overdose of any substance could cause death, while morphine is more lethal then many others, I don't think on a wiki article about the drug that it should be refereed to as a poison. Could we just change it to say: The latter is an medicine to reverse the effects of the drug. Or something similar. I could be wrong about this, perhaps in this case poison should in fact be used, so if someone could offer their opinion before I change it. 66.190.244.233 (talk)

Morphine has no acute organ toxicities so you are right in that it'd be technically incorrect to call it a poison. Even if for legal reasons some companies put "poison" on tinctures of opium (some constituents, namely thebane, in opium are poisons however, they have that as correct on a technicality, but mu agonist opioid narcotic pain killers are not per strict medical definition poisons.) Nagelfar (talk) 14:16, 30 August 2010 (UTC)

2D image plate of the anion salts from the named salts given in the article?

The structure of morphine is an interesting link with many molecular images of morphine in different stages/conformations which may be of some use. It is similar to a idea of mine seeing as many anion salts of morphine are given well in a nested form in this article under the Forms of morphine, salts & chemical form to freebase conversion ratios, and one doesn't often see how the different anion salts appear along with their two dimensional molecule image respective that they are the salt of, someone would be doing wikipedia a favor to make a plate of many small instances in rows and columns bundled with the nested list of them I was thinking. ("Anion salt" as a term for such salts when added to a freebase molecule, also deserves its own page I was too thinking, as one may guess from my linking the word above.) Nagelfar (talk) 15:06, 4 August 2010 (UTC)

This link here speaks a little on the solubility of the different salts of opioids and morphine in particular, maybe one could use this to add to that conversion table in the article, besides the freebase conversion ratios, the solubility of each salt of morphine in addition. Nagelfar (talk) 14:10, 30 August 2010 (UTC)

9B1 anti-morphine antibody?

Three analogs of morphine are proposed based on the protein crystal structure of the 9B1 anti-morphine antibody reported by Pozharski et al. (2004). There is nothing on Wikipedia currently regarding this. The morphine analogues in the above .pdf are of interest as well. Nagelfar (talk) 10:00, 23 December 2010 (UTC)

Too big and poorly formatted

While this may offend the person who created it I consider this to be too big...

Indications: Pain relief or analgesia Cough suppressance Antidiarrheal effects Recreational uses: Antidepressant effects Anxiolysis Drowsiness or somnolence (nodding) Euphoria Relaxation Sedation Stress relief

Contraindications: Dissociatives like ketamine (K), phencyclidine (PCP), dextromethorphan (DXM), and nitrous oxide (N 2O) Sympatholytics like alpha blockers and beta blockers Tranquilizers like alcohol (ethanol), gamma-Hydroxybutyrate (G, GHB), barbiturates, benzodiazepines, and nonbenzodiazepines Other opiates and opioids (narcotics or analgesics) Miscellaneous depressants, anesthetics, hypnotics, and sedatives

Side effects: Cardiovascular: Bradycardia or decreased heart rate Cardiac arrest, cessation of heartbeat, or heart failure Hypotension or decreased blood pressure Palpitation or abnormal heartbeat Faintness or syncope Flushing of the face Orthostatic hypotension or very low blood pressure Ear, nose, throat, and skin: Flushing Pruritus or itching Xerostomia or dry mouth Eye: Intermittent blurring Pupil constriction or miosis Visual distortions Gastrointestinal: Constipation Nausea and vomiting or emesis Hepatological: Hepatotoxicity or liver damage (due to acetaminophen or paracetemol (APAP; Tylenol) in many morphine preparations) Liver failure (again, due to acetaminophen) Renal failure or kidney failure Musculoskeletal: Fasciculation or muscle twitch Neurological: Analgesia Psychological: Antidepressant effects Anxiolysis Confusion Drowsiness or somnolence (nodding) Dysphoria Euphoria Relaxation Sedation Stress relief Respiratory: Bradypnea or slow breathing Dyspnea or shortness of breath Hypoventilation, respiratory depression, or shallow breathing Respiratory acidosis or an abnormal decrease in the pH of the blood Respiratory arrest or cessation of breathing Miscellaneous/Severe: Miscarriage or spontaneous abortion Coma or unconsciousness Death or termination of life

Doc James (talk · contribs · email) 19:04, 23 January 2011 (UTC)

I agree. That's why I shortened it and removed certain parts which were of doubtful factual accuracy --- analgesia is not an adverse effect, nor is reduction of stress. Those are beneficial effects; no patient is ever going to complain of being in less pain. --Nmatavka (talk) 00:11, 14 June 2011 (UTC)

OTC information

In some areas, notably England, morphine is sold over the counter as a weak pain killer and antidiarrhoeal; it fills the role played by codeine in other countries. This is in spite of morphine being listed as a class A drug; although the penalties for its unauthorised possession and supply are dire, it continues to be sold behind the counter. I didn't know where to put this, so I'm leaving it up to you all. --Nmatavka (talk) 23:46, 13 June 2011 (UTC)

Withdrawals

Obviously the person that wrote the articla on morphine withdrawals has never been addicted to morphine, nor have experienced the withdrawals. I have, and I can tell you that the information is not correct. Not even close. This person makes it sound like you have some heart palps and some diarhea and then you are done. If only it were that easy. Trust me when I tell you that morphine withdrawal is like having your bady put into a wood chipper, all your nerve endings feel like the are being burned with fire, and your head feels like it will explode. And that is the milder symptoms. I know, because I am experiencing withdrawal as I am typing this. The withdrawal do not get easier with each passing day. They get worse. I have been withcrawing for 4 days now, and with each day the withdrawal symptoms have increased. I find it particularly annoying when people write articles about something they now little or nothing about. Many apologize, I am not feeling myself at the moment. — Preceding unsigned comment added by Sharmari (talk • contribs) 18:51, 5 July 2011 (UTC)

Morphine Chemistry Section: One Major Mistake

"A number of salts of morphine are used.... Morphine acetate, which is another name for heroin is a Schedule I controlled substance."

No. Morphine acetate is the ammonium salt of acetic acid. It is not the name for heroin. Heroin is diamorphine or diacetylmorphine. The names differ inherently ("-yl" as in "acetyl" vs "-ate" as in "acetate) because the acetate in morphine acetate is an anion. Morphine acetate is a salt form just like Morphine sulfate (note: the "-ate" suffix is not a coincidence). The majority of the oxoanions get the "-ate" suffix. The other suffix used is "-ite" and there are special rules that detail how to affix prefixes ("hypo-," "per-") as well. The "Acetyl" (suffix "-yl") in the CORRECT name for heroin reflects the covalent, rather than ionic, nature of the bonds between the TWO ("di-" prefix) equivalents of acetic acid.68.6.76.31 (talk) 02:48, 30 January 2012 (UTC)

Morphine half-life

http://www.nhtsa.gov/people/injury/research/job185drugs/morphine.htm "Morphine has a short half-life of 1.5 - 7 hours". Electron9 (talk) 13:38, 16 March 2012 (UTC)

Withdrawal

I saw that someone else had said the part about withdrawal is terribly inaccurate. I would have to say I agree. I am also 72+ from stopping morphine which I was on for 6 months. I never took more than I was supposed, and always, always took it the correct amount of hours apart. I decided to stop in abruptly because of some issues I was having with it.

The withdrawal is horrific. To explain it in a matter a fact way, it is like having the flu times ten. I have had everything from the restless legs to very significant bone pain, especially wherever I've had surgery.

I would highly suggest that anyone who is stopping this medication go to their doctor, or if you cannot see a doctor go to the ER. There are massive complications that you would or could not foresee.

Some of the withdrawal effects can be life threatening. Anyone going off this medication should be under a doctor's care. You can go in and say you refuse any pain treatment and just treat the symptoms. There is a huge difference between your body have a withdrawal reaction and be a person being addicted to it. Mentally I feel fine going off this medication, I want off this medication, but it is very, very hard.

At times it feels like you are having a heart attack and then next it feels like your intestines are trying to crawl out of your body.

There are great medications (non-addictive) that can greatly reduce the symptoms but it won't take them away completely. But it will help your chances of successfully ridding yourself of the medication.

More needs to be looked into and studied regarding the withdrawal of morphine. The timeline here is a little inaccurate. The heavy withdrawal symptoms actually last 7 to 10 days and sometimes longer. I heard this from my doctor and 4 other nurses that were helping to treat me during my doctor visit.

There really should be a statement somewhere on here that says you should see a doctor either before or after stopping this medication if you are having any withdrawal symptoms. — Preceding unsigned comment added by Starwaterlily123789 (talk • contribs) 17:29, 15 December 2013 (UTC)

Merge morphine total synthesis

I requested that morphine total synthesis be merged with this article. While this is already bloated, the total synthesis article contains almost no information and really isn't a free-standing article topic.

I strenuously object to this request, see further comment near end of thread, with this same date. Le Prof 71.239.82.39 (talk) 03:30, 30 April 2014 (UTC)

In other news, I'm trying to pair down this article's length by simplifying the pedantic language.

Exercisephys (talk) 00:15, 19 January 2014 (UTC)

Exercisephys, why do you say that this is not a free-standing article topic? There certainly are lots of papers cited for morphine synthesis. It seems highly specialized to me, and I would not expect to see a complete discussion of synthesis in the article for any drug. I have not thought much about this, but my initial thought is that I would rather have the synthesis for drugs put into their own articles. I am not aware of any precedent for including synthesis information in drug articles. Blue Rasberry (talk) 17:44, 21 January 2014 (UTC)

Bluerasberry, the entire article contains four sentences and one novel image. More importantly, no other drug has a separate synthesis page. This includes drugs with far more storied synthesis histories, like methamphetamine and LSD. There is a lot of published research on the synthesis of every drug, but most of it is out of the scope of Wikipedia. Exercisephys (talk) 20:06, 21 January 2014 (UTC)

Exercisephys, the other drugs also do not have synthesis sections like this (see methamphetamine). Would you more favor a merge or deletion of this content for being out of scope? I think that I would wish for this information to exist for every drug, but am not sure yet. Why do you say that this is out of scope? Please tell me a bit more about what you think should happen with this content. Blue Rasberry (talk) 21:47, 21 January 2014 (UTC)

Bluerasberry, all but the very basics of drugs' syntheses are too arcane for Wikipedia, as per notability standards. There is no reason or need to make a synthesis page for all drugs, and I can assure you that other drug page editors will not approve. A paragraph or two and an image or two generally suffices; that certainly doesn't merit a separate article. Exercisephys (talk) 02:58, 22 January 2014 (UTC)

Exercisephys Are you proposing to merge this content or delete it? You proposed a merge, but now seem to be saying that it is too arcane for Wikipedia. I have doubts that most people seeking information on morphine would be going to the article to learn about the synthesis, so my thought was it would be WP:UNDUE to have it there and better to keep this in its own article. Do you really want all of this information moved to the morphine article? Blue Rasberry (talk) 14:46, 22 January 2014 (UTC)

Bluerasberry, I hate to be so blunt, but you're wrong on this one. We can beat this dead horse, but it's pretty cut-and-dry. Drug pages have their synthesis information (much less their total synthesis information) in their main article. In response to your other question, I'm planning on merging all the information in morphine total synthesis into morphine. Please ask around more before continuing this discussion, because this is a very simple issue. Exercisephys (talk) 14:54, 22 January 2014 (UTC)

Bluerasberry, Exercisephys I hate to wade in to your discussion but a cleanup and merge seems the best option here. To go into enough detail on morphine synthesis to warrant an article would require an level of academics not appropriate for a wiki page. That said some of the synthesis details would fit well and be apt on this article. I can't work otu who wants what but that's my 2c.SPACKlick (talk) 15:00, 22 January 2014 (UTC)

Exercisephys SPACKlick Please pause the merge. There is precedent for this page at Category:Total synthesis. It may be the case that pages like morphine total synthesis and other "total synthesis" articles should not exist, but as a chemist, these seem like worthwhile articles to me. How do you two feel about the other articles in this category? Should the other total synthesis articles be queued for merging as well? If either of you want to talk by phone or video then message me at Special:EmailUser/Bluerasberry. If this is a dead horse or you are not enjoying this conversation then feel free to drop out as you like and I will arrange for other comments. It is not my intent to obligate you to do things you do not wish to do. Blue Rasberry (talk) 15:05, 22 January 2014 (UTC)

Bluerasberry, Ok, having looked at some of the other total synthesis pages I've completely changed my mind, if the morphine total synthesis page was expanded it would fit very well among that category and it looks like there's a lot of expansion possible. Therefore I'd recommend a serious improvement/expansion rather than a merge. SPACKlick (talk) 15:12, 22 January 2014 (UTC)

Bluerasberry, SPACKlick, half of the articles in that category are incredibly dense and not notable, and the other half are just chemicals' articles that mention total syntheses. I'm definitely of the opinion that most of those total synthesis articles shouldn't exist. We could start a larger discussion with people like Seppi333 and Boghog on this, but I'm pretty confident that the way things are currently done is justified. Exercisephys (talk) 15:36, 22 January 2014 (UTC)

Exercisephys, could you please clarify your position? When you say "most of those total synthesis articles shouldn't exist", "A paragraph or two and an image or two generally suffices", or "all but the very basics of drugs' syntheses are too arcane for Wikipedia", are you arguing that some of this information be deleted outright from Wikipedia, or are you just looking to position it differently? I am still not clear on whether we are talking about rearrangement or deletion. If I understand you correctly, you feel this information is too complicated for most people, but at the same time you want it more prominently featured in the main article for a drug, and I am having trouble understanding why you would feel this is best. Blue Rasberry (talk) 15:42, 22 January 2014 (UTC)

Bluerasberry, I think I've made myself pretty clear, but I'll reiterate. I think that all of the information in morphine total synthesis should be preserved, but moved to morphine. However, examples like this are completely indefensible in their abstruseness and lack of notability. Additionally, they seem to have been almost all created and written by a single author, V8rik. I'll probably take up their deletion as a separate project.— Preceding unsigned comment added by Exercisephys (talk • contribs) 15:56, 22 January 2014 (UTC)

Again, strenuously object, see comment near end of thread, from me, with same date. Le Prof 71.239.82.39 (talk) 03:29, 30 April 2014 (UTC)

There's actually a mutually satisfactory solution to this problem if you're willing to do something a tad unorthodox, although I've already done it on both amphetamine and methamphetamine.

I'll explain why a synthesis section needs to be on this page first though; because this page is covered by WP:Chemicals, part of its style and section layout is derived from WP:CHEM (similarly for WP:MED/WP:PHARM with MOS:MED and MOS:PHARM). MOS:CHEM is where the precedent to include a synthesis section (or biosynthesis, in the case of compounds like psilocybin) in the body of the article comes from.

Now, with that said, this can be merged and remain on a separate page by transclusion. If the only concern is categorization of the total synthesis, duplication of the article can be avoided and categorization maintained by simply moving the article to either a subpage of this talk page or template space.

The end result will be something along the lines of this: Category:Metabolic pathways (look for the 2 unusual category entries), Methamphetamine#Pharmacokinetics, and Amphetamine#Pharmacokinetics. Seppi333 (Insert 2¢) 16:04, 22 January 2014 (UTC)

Seppi333 - that is interesting. You are transcluding the synthesis in multiple articles as listed in Special:WhatLinksHere/Template:Amphetamine_Pharmacokinetics. I agree that if you want to show the synthesis in many places, this does seem like a reasonable way to do it, but why did you choose to show the synthesis repeatedly as a template instead of just putting it into its own Wikipedia article? It would have seemed less surprise to me if you had just repeatedly linked to one article showing the synthesis. Also, how do you feel about synthesis articles like Nicolaou Taxol total synthesis, which would not be put into templates or repeated, but instead give deeper descriptions of the processes? Thanks for doing that template thing - I have never seen something like that done and it seems like a useful process for managing subsections which are going to appear repeatedly in any class of articles. Have you seen that done elsewhere? Blue Rasberry (talk) 16:27, 22 January 2014 (UTC)

Bluerasberry, I actually didn't read the whole thread - just skimmed, so I probably missed something since I figured the main concern was an independent page with categorization. I actually don't have an opinion on that article since there is a precedent for a synthesis article and categorization. A large total synthesis should reasonably be separate from the main article simply due to summary style. That said, an option I didn't mention, but might be suitable to both parties, is to merge the article, turn the total synthesis into a section redirect, and categorize the redirect as total synthesis. Seppi333 (Insert 2¢) 16:49, 22 January 2014 (UTC)

Seppi333, thanks, that is helpful, and thanks also for showing me that template/categorization trick. I can imagine that solving a lot of problems in lots of places and I will not forget that. I would not oppose this article being moved to a template if someone thought that would be useful. Blue Rasberry (talk) 16:52, 22 January 2014 (UTC)

Rarely would a separate article on the synthesis a drug be justified. However I think morphine represents one of those rare exceptions.

Two recent review articles have been published about the subject (see PMID 21547687 and PMID 21630507) which documents its importance. Furthermore, the subject has significance that is broader than morphine. First, the laboratory synthesis of morphine will never be able to compete commercially with extraction of morphine from natural sources. The real value of the development of synthetic routes to morphine is that they can be adapted to produce analogs of morphine which may have improved properties. Second, morphine to this day has remained a challenging synthetic target which has encouraged the development of new synthetic methodologies which may have applications distant to morphine (analogous to some of the new technologies that were developed for the space program). Boghog (talk) 21:44, 22 January 2014 (UTC)

Concur with Bohog, where the mutual analogies to the space program was unplanned and accidental. Great minds... Le Prof 71.239.82.39 (talk) 03:29, 30 April 2014 (UTC)

Bluerasberry, I'm a little confused; are we now all in support of the merge? Exercisephys (talk) 23:17, 22 January 2014 (UTC)

Exercisephys My position:

1. Favor merge for any small amount of content
2. Oppose deletion of any content without consultation
3. Morphine total synthesis is currently a small amount of content, but would support a fork back to its own article if more content added to this, such as what Boghog is presenting
4. Favor the creation of synthesis templates as described by Seppi333 so that it can be noted where total synthesis content exists; this is a cool system, but a typical merge is okay too
5. Disagree with Boghog and Exercisephys - Wikipedia is a specialized encyclopedia and an appropriate place to host total synthesis articles or sections. If the total synthesis section of any article is WP:UNDUE, fork the content into its own article. If there is a reason to delete total synthesis content, it is beyond citing WP:N alone as justification and I would want to solicit broader conversation.
6. If anyone ever argued that a total synthesis was UNDUE in an article about a chemical, I would never disagree, because it almost always beyond what is necessary. In such a case I would recommend a fork over deleting the content outright.

Cool? Blue Rasberry (talk) 00:54, 23 January 2014 (UTC)

Another reason not to merge is that many of the syntheses cited in the article are not of morphine but close analogs of morphine such as dihydrocodeinone (Rice) and codeine (Trost). Therefore the morphine total synthesis article is misnamed. It really should be called synthesis of morphine and related alkaloids or something similar. Boghog (talk) 00:58, 23 January 2014 (UTC)

Clarification: Codeine can be easily converted into morphine in one chemical step. Hence a total synthesis of codeine represents a formal synthesis of morphine. Nevertheless there are still a few cited syntheses in the article that produce analogs of morphine that cannot readily be transformed into morphine, hence they are not in the strictest sense morphine syntheses. Boghog (talk) 02:47, 23 January 2014 (UTC)

Boghog, I don't really see the justification for keeping it a separate page. These are difficult syntheses, but so are things like salvinorin A, and they don't have synthesis pages. There really isn't enough notable information on a subject like this to fill an article. There are new journal articles like that on the synthesis of any societally relevant chemical, but that doesn't merit a new Wikipedia article. On the other hand, I don't have much time to handle this stuff right now so I'm going to be a little sporadic in my responses. Exercisephys (talk) 19:12, 23 January 2014 (UTC)

Given what Boghog pointed out about Codeine on the page, it should probably be transcluded instead. There's at least 2 articles its applicable to and both need a synth section. Seppi333 (Insert 2¢) 20:25, 23 January 2014 (UTC)

Sorry, but can you define transcluded in this context? Exercisephys (talk) 20:54, 23 January 2014 (UTC)

Forgot to respond to your Q - transcluding is basically just copying a live version of a page on another, though it's typically only done from templates or project pages. The main drawback of doing it from an article is that it can become a lot harder for the average person to edit, especially when it uses noinclude and includeonly tags. Seppi333 (Insert 2¢) 21:47, 23 January 2014 (UTC)

I'm transcluding that page here using |page=Morphine in the parameter I defined.I added a caption parameter for the image as well. This page will need to be purged/dummy edited (e.g., add a whitespace) to update the transclusion from an edit performed on Morphine total synthesis though. I added some formatting to the page to transclude the relevant parts. It needs an intro section within the includeonly tags that's applicable on other pages though. Seppi333 (Insert 2¢) 21:01, 23 January 2014 (UTC)

Transclusion tab removed by Seppi333

Exercisephys, I think the strongest justification for keeping a separate total synthesis article is to reduce the amount of duplicate information that is included in a number of morphine alkaloid family articles. I propose that the article's scope be expanded so that it includes not only the synthesis of morphine, but also the closely related codeine, oripavine, and thebaine as well as the semisynthetic analogs buprenorphine, hydrocodone, isocodeine, naltrexone, naloxone, nalbuphine, and oxycodone. A central article can also include the chemical routes for interconversion of these closely related alkaloids as well as treat the subject in more depth than any of the individual articles. The present article is rather short but could be significantly expanded. I have already expanded it slightly and will work to expand it further. If expanded, this material would overwhelm the individual articles. Boghog (talk) 21:33, 23 January 2014 (UTC)

We may need to transclude a partial copy of this page from template space or paste the appropriate content into relevant articles given how AWB treats parameters in the mainspace. Seppi333 (Insert 2¢) 00:56, 25 January 2014 (UTC)

Edit: nm, I just noticed my AWB doesn't do this. Not sure what the best way to proceed is tbh. Seppi333 (Insert 2¢) 02:31, 25 January 2014 (UTC)

Boghog, I'm going to let you finish writing the synthesis page before I bother tinkering with the layout for transclusion, so I'm removing the transclusion parts for now. I'll leave it up to you to decide if its worth making a separate template for transcluding onto Codeine/Morphine/etc when you're done. Seppi333 (Insert 2¢) 13:38, 25 January 2014 (UTC)

I generally concur with any effort to group synthetic articles for related members of natural products into the same natural products synthesis article; I disagree with deletion of the underdeveloped of such articles where the subject is of chemical methodologic or historic importance (where morphine is of both). At present, both the Total synthesis article, and many of the individual NP synthesis articles are weak, and many that are not, are instead too highly specialized (e.g., strychnine total synthesis). The former issue does not reflect the lack of notability of the science, but rather the failure of Wikipedia to attract subject matter experts needed to create this highly sophisticated content; given that the best representation of the schemes required are copyrighted, each image has to be constructed by a subject matter expert. (I for one simply do not have time to contribute such, and I am much more open to contributions here than most of my colleagues.) Relatedly, some of the overly technical articles, when scholarly and well-referenced, should be tolerated—as a starting point for producing a more generally approachable article, and in hopes of retaining the subject matter experts that are contributing. I would also note that to see such articles as being primarily articles about the synthesis of a drug is very far beside the point. For the most part, new synthetic methodology is not developed by pharma, en route to commercial preparations of new drugs (because tried and true methodology is required, for cost and other reasons); new methods to make molecules most generally are developed (just as new technologies were developed in the target-orented race to the moon) when complex targets are chosen for synthesis, and significant efforts are made to achieve those targets. This is the proper light to see alkaloid synthesis, this alongside its important historical roles. See my comment, this same date, regarding the poor state of the Total synthesis article. Finally, that all natural products do not have separate synthesis pages is immaterial — for practical and historical reasons, not all are noteworthy. All should certainly begin as a section within the main article, but if the importance of the synthesis to the history of understanding the function of the molecule, or to its contributions to methodology or other chemical concepts expand, it should receive the separate coverage as morphine does. Le Prof 71.239.82.39 (talk) 03:28, 30 April 2014 (UTC)

May be a moot issue now, but in case there's any interest: an example of article to article transclusion I've done in the meantime is 3 section transclusions from amphetamine on Adderall. I even made my own hatnote template {{transcluded-section}} for it. ;) Seppi333 (Insert 2¢ | Maintained) 04:26, 30 April 2014 (UTC)