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 DRUGS
The Straight Facts

Morphine
DRUGS The Straight Facts

AIDS Treatment Drugs

Alcohol
Alzheimer’s Disease and Memory Drugs
Anti-Anxiety Drugs
Antidepressants
Barbiturates
Birth Control Pills
Body Enhancement Products
Cancer Drugs
Cocaine
Codeine
Date Rape Drugs
Designer Drugs
Diet Pills
Ecstasy
Hallucinogens
Heroin
Inhalants
Marijuana
Morphine
Nicotine
Opium
OTC Drugs of Abuse
Peyote and Mescaline
Prescription Pain Relievers
Ritalin and Other Methylphenidate-Containing Drugs
Sleep Aids
 DRUGS
The Straight Facts

Morphine

Gregory D. Busse

Consulting Editor
David J. Triggle
University Professor
School of Pharmacy and Pharmaceutical Sciences
State University of New York at Buffalo
Morphine

Copyright © 2006 by Infobase Publishing

All rights reserved. No part of this book may be reproduced or utilized in any
form or by any means, electronic or mechanical, including photocopying,
recording, or by any information storage or retrieval systems, without permission
in writing from the publisher. For information contact:

Chelsea House
An imprint of Infobase Publishing
132 West 31st Street
New York NY 10001

Library of Congress Cataloging-in-Publication Data

Busse, Gregory D.
Morphine/Gregory D. Busse.
p. cm.—(Drugs, the straight facts)
Includes bibliographical references.
ISBN 0-7910-8551-1
1. Morphine—Juvenile literature. 2. Opium—Juvenile literature. I. Title.
II. Series.
RM666.M8B87 2005
362.29'3—DC22 2005 021242

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 Table of Contents
The Use and Abuse of Drugs
David J. Triggle, Ph.D. 6

1. The History of Opium and Morphine 8

2. The Movement of Morphine Through the Body 23

3. Morphine’s Effect on the Nervous System 33

4. Morphine and Pain 42

5. Alternatives to Morphine in Managing Pain 52

6. Morphine Addiction and Dependence 60

7. Heroin Abuse 69

8. Treatment of Opiate Addiction and Dependence 78

Glossary 88

Bibliography 91

Further Reading 94

Websites 95

Index 96
The Use and Abuse of Drugs
The issues associated with drug use and abuse in contemporary
society are vexing subjects, fraught with political agendas
and ideals that often obscure essential information that teens
need to know to have intelligent discussions about how to
best deal with the problems associated with drug use and
abuse. Drugs: The Straight Facts aims to provide this essential
information through straightforward explanations of how an
individual drug or group of drugs works in both therapeutic
and non-therapeutic conditions; with historical information
about the use and abuse of specific drugs; with discussion of
drug policies in the United States; and with an ample list of
further reading.
From the start, the series uses the word “drug” to describe
psychoactive substances that are used for medicinal or non-
medicinal purposes. Included in this broad category are
substances that are legal or illegal. It is worth noting that
humans have used many of these substances for hundreds, if
not thousands of years. For example, traces of marijuana and
cocaine have been found in Egyptian mummies; the use of
peyote and Amanita fungi has long been a component of
religious ceremonies worldwide; and alcohol production and
consumption have been an integral part of many human
cultures’ social and religious ceremonies. One can speculate
about why early human societies chose to use such drugs.
Perhaps, anything that could provide relief from the harsh-
ness of life — anything that could make the poor conditions
and fatigue associated with hard work easier to bear — was
considered a welcome tonic. Life was likely to be, according
to the 17th century English philosopher Thomas Hobbes,
“poor, nasty, brutish and short.” One can also speculate
about modern human societies’ continued use and abuse of
drugs. Whatever the reasons, the consequences of sustained
drug use are not insignificant — addiction, overdose, incar-
ceration, and drug wars — and must be dealt with by an
informed citizenry.

6
 The problem that faces our society today is how to break
the connection between our demand for illegal drugs and the
willingness of largely outside countries to supply this highly
profitable trade. This is the same problem we have faced
since narcotics and cocaine were outlawed by the Harrison
Narcotic Act of 1914, and we have yet to defeat it despite
current expenditures of approximately $20 billion per year on
“the war on drugs.” The first step in meeting any challenge
is always an intelligent and informed citizenry. The purpose
of this series is to educate our readers so that they can
make informed decisions about issues related to drugs and
drug abuse.

SUGGESTED ADDITIONAL READING

David T. Courtwright, Forces of Habit. Drugs and the Making

of the Modern World. Cambridge, Mass.: Harvard University
Press, 2001. David Courtwright is Professor of History at the
University of North Florida.

Richard Davenport-Hines, The Pursuit of Oblivion. A Global

History of Narcotics. New York: Norton, 2002. The author
is a professional historian and a member of the Royal
Historical Society.

Aldous Huxley, Brave New World. New York: Harper & Row,
1932. Huxley’s book, written in 1932, paints a picture of a
cloned society devoted only to the pursuit of happiness.

David J. Triggle, Ph.D.

University Professor
School of Pharmacy and Pharmaceutical Sciences
State University of New York at Buffalo

7
1
The History of
Opium and Morphine
On a cool, brisk, October morning, John wakes up, stumbles into
the bathroom nauseous and dizzy, and begins his daily routine.
As he looks at his unshaven, leathery face in the mirror, he real-
izes that today marks the five-year anniversary of the day he was
wounded in battle, as well as the first day he was given morphine
by medics to relieve the pain of the wound. Although, at first,
this drug was very effective at lessening his discomfort, its pain-
relieving properties dissipated with continued use. In fact, after
years of morphine therapy, John was only left with an urge for the
drug’s euphoric effects. John, like many other wounded soldiers
before him, has become an opiate addict. He begins each day
like every other day. Specifically, he reaches into the bathroom
cupboard, pulls out a wooden box, and begins to prepare his
morphine injection.

THE OPIATES
Although this scenario represents an example of medical morphine
use leading to addiction and dependence—an occurrence that is
actually somewhat rare today—the potential for such effects are nei-
ther new nor surprising given this drug’s origin. Interestingly, mor-
phine is obtained from the same plant that produces opium, the
poppy plant (Figure 1.1). Together, morphine and opium belong to
a larger family of drugs named the opiates, which are known for
producing a wide range of effects, from sedation to constipation.

8
 Figure 1.1 Both opium and morphine are derived from a
certain kind of poppy plant, shown here.

Today, however, they are most commonly used for the

management of pain (Table 1.1).
Using opiates will result in a myriad of physiological and
psychological effects. For example, in addition to pain relief,

9
10 MORPHINE

Table 1.1 Selective List of Opiates

Morphine

Heroin

Hydromorphone

Oxymorphone

Codeine

Hydrocodone

Drocode

Oxycodone

Levorphanol

Methadone

Fentanyl

Nalbuphine

Propoxyphene

Buprenorphine

Pentazocine

Butorphanol
 The History of Opium and Morphine 11

beneficial effects like anesthesia and relief from diarrhea occur

when someone takes a single dose of morphine. The fact that
opiates have the ability to produce effects like these clearly
indicates that these drugs have a utility beyond the management
of pain. Unfortunately, many of these effects will change with
the continual use of these drugs. That is, chronic (long-term)
opiate use reduces these drugs’ ability to produce effects like
pain relief and sedation. Moreover, continual opiate use can
lead to addiction and dependence. In fact, for the addict,
habitual opiate use can result in intense cravings for the drug,
compulsive use, and, if abruptly stopped, withdrawal. To this
end, the discovery and use of the opiates have been both a
blessing that has benefited society and a plague that has
affected many an unsuspecting user.

OPIATES AND THE BODY

The beneficial and detrimental effects of opiates result from
their interaction with the ongoing biological processes within
the body (see Chapters 3, 4, and 6). For example, opiates alter
the functioning of specialized cells called neurons. Neurons
are found in great abundance in the brain and spinal cord
(the central nervous system ), as well as in and around
muscles, organs, and tissues (the peripheral nervous system.
Neurons are specialized in that they can communicate with
other neurons. The movement of information among neurons
gives people the ability to sense and perceive things like
temperature, light, and sound. Neuronal communication also
allows us to experience emotions, think, and produce coordi-
nated movement. Thus, by altering neuronal communication,
opiates can affect our feelings, cognition, and behavior.
Opiates produce effects like pain relief and addiction by
affecting subsets of neurons responsible for the sensation and
perception of pain (see Chapter 6) and euphoria (a sense of
well-being; see Chapter 5). Opiates produce their effects
because they either enhance or lessen the neurons’ ability to
12 MORPHINE

Figure 1.2 Top: global opium production in metric tons from 1990 to 2002.
Afghanistan is the world’s leading producer of opium, followed closely by
Myanmar (formerly known as Burma). Other countries notorious for producing
opium include Laos, Mexico, and Colombia. Bottom: global opium production
in metric tons from 2001 to 2002 based on geographical location. Though
opium was traditionally smuggled into North America from the Far East,
opium production has been on the rise in Mexico and Colombia, decreasing
the distance the drug has to travel to reach the United States.
 The History of Opium and Morphine 13

convey information about these sensations to other neurons.

The net result of this action is a deadening of pain and/or
heightened sense of euphoria.
Opium and morphine have a long history of use both
recreationally and medically, and, not surprisingly, opium
production continues to rise (Figure 1.2). Reflection on the
history and effects of these drugs has fueled a great desire to
find alternatives to opium and morphine. In fact, this has been
the guiding principle in opiate research: if alternatives to
opium and morphine can be discovered and/or synthesized
based on how opiates work within the body, it may be possible
to use these new drugs to produce effects like pain relief
without the accompanying risk of addiction and dependence.
As you will see, the results have been mixed. Still, it is hard to
imagine modern medicine without the opiates, given their
integral place in the physician’s toolbox.

“Among all the remedies which it has pleased almighty

God to give man to relieve his suffering, none is so
universal and efficacious as opium.”
—Thomas Sydenham, considered to be
the father of clinical medicine (circa 1680)

OPIUM
Morphine is one of the principal ingredients of opium, a drug
that has been, by far, one of the most influential, popular, and
commonly used and abused substances in human history.
Opium is a naturally occurring drug that is cultivated directly
from the poppy plant (Papaver somniferum; Figure 1.3). Poppy
plants typically grow to a height of 3 or 4 feet. On top of
the stalk, there is a large globe-like bulb that contains the
seeds of the poppy plant. Surrounding the bulb are the petals
of the poppy flower. Although the flowers vary based on
species and growing conditions, the opium-producing poppy
14 MORPHINE

Figure 1.3 The opium poppy is the source of opium, morphine,

and heroin. Laborers incise the poppy pod, letting the opium sap
seep out. The opium resin is then packaged into cakes and sent
to the opium market.

plant is usually marked by the presence of white or purple

flowers and a bulb that contains yellow seeds.
Although the poppy plant was at one time quite abundant
throughout parts of Europe, the Middle East, and Asia, today
only four countries—Australia, France, Spain, and Turkey—
legitimately grow poppy plant crops for medicinal use. That
is, these countries have been sanctioned to grow poppy plants
by the United Nations International Narcotics Control Board
 The History of Opium and Morphine 15

in order to meet the world’s opiate needs. This is not to say

that poppy plant crops are not grown elsewhere. In fact,
unregulated crops of poppy plants are found in great abun-
dance in Myanmar (formerly known as Burma), Laos, Thailand,
Afghanistan, Mexico, and Colombia. The production of opiates
in these countries, however, is usually for illicit black-market
trade rather than medicinal use.
The harvesting and selling of opium has not changed
much over the past millennia. As the poppy plant ripens, the
flowers that surround the poppy plant’s pod fall off, exposing
the bulb. Once this occurs, there is a noticeable drooping in the
stalk of the plant. Laborers then quickly go into the poppy
fields and methodically score the pods with a small harvesting
blade. As a result of this process, the opium sap that resides
within the pods (at this point, it is milky-white sap) will ooze
out at the site of the incisions and adhere to the pod. During
the next 12-hour period, the sap turns brown as it interacts
with the air (that is, it oxidizes).
The next day, laborers then return to the fields and scrape
the brown opium resin off the pods. After scraping, the opium
resin is then packaged into cakes, which are shipped to and
stored in large warehouses until it is time to send them to the
opium market. At the market, the opium cakes are rated based
on quality and purity, priced, and eventually bought by opium
dealers. From the market, opium may be sent anywhere in
the world where a demand for opium, morphine, or heroin
(heroin is also made from opium) exists.

MEDICINAL AND RECREATIONAL OPIUM USE

For over a millennium, the ability of opium to immediately
relieve pain, induce sleep, and stop diarrhea was matched by
no other drug. For this reason, opium, and opium-laced
tonics like laudanum (opium mixed with wine and spices)
were very attractive medicines to both physicians and patients
alike. In fact, most of the earlier references to the poppy plant
16 MORPHINE

and opium (from Sumerian, Egyptian, Greek, Roman, and

Arab texts) indicate that people were keenly aware of the
therapeutic benefits of this drug early in history. However,
it is also clear that these earlier civilizations knew of
opium’s ability to produce euphoria, an effect that may lead
to addiction and dependence.
The Sumerians (a society that thrived approximately
5,000 years ago) used the words hul, meaning “joy,” and gil,
meaning “plant,” when referring to the poppy plant. This
evidence suggests that it has been known for at least 5,000 years
that ingesting opium would result in a euphoric sensation.
There is also evidence that the ancient Greeks knew that the
use of opium would quickly turn to misuse if it were not
regulated in some way. For example, early Greek writings from
Hippocrates and Galen indicate that, although poppy-based
medicines were commonly used to ease pain and induce sleep,
large enough quantities could produce dependence and death
if this drug was not taken in a controlled manner. These
writings clearly show that the Greeks knew that long-term
opium use had the potential to result in intense cravings for
the drug, compulsive use, and, if abruptly stopped, severe
withdrawal symptoms.
Thus, although the practice of using opium as a medicine
has been around for many years, the non-therapeutic qualities
of this drug were realized early in its history. With no other
drug available to match opium’s potency and efficacy (its
potential to produce maximal effects based on the dose of drug
given), however, using opium as a medicine to treat ailments
like pain, dysentery, and insomnia would remain popular for
many centuries.
As the population of the world expanded and became
more interconnected and industrialized over time, the medici-
nal use and subsequent abuse of opium (and laudanum) would
increase as well, reaching a zenith in the 18th and 19th centuries
(see “The Opium Wars” box). During this time period, there
 The History of Opium and Morphine 17

were several factors that contributed to the rapid spread of

opium use and abuse throughout Asia, Europe, and North
America. The frequent trading of goods between Europe and

THE OPIUM WARS

In the 18 th century, the British loved Chinese tea, but
had great difficulties obtaining this product. Given that the
Chinese viewed all things foreign as barbaric, the value of
British-borne products was somewhat limited to the Chinese.
The answer to the British-Chinese trading problem would
come in 1773, when British forces conquered the Bengal
Province in India, then the world’s leading producer of
opium. With this victory, the British had a monopoly on the
production and sale of opium. As such, the British now had
an ideal commodity for trade with the Chinese.
Trading opium to China for Chinese goods proved quite
a lucrative business for the British. The Chinese not only
desired opium for its medicinal value, but soon for recre-
ational purposes. Not surprisingly, as use of opium increased
within the Chinese population, an opium epidemic would soon
grip China. The Chinese Emperor responded to this problem
by issuing an edict banning all opium use by the population.
Unfortunately, this failed to curb the problem and, in 1839,
the Emperor ordered Chinese forces to confiscate and
burn all opium brought in by British ships. Thus, the
Opium Wars began.
For approximately 3 years, the British and Chinese fought
until, finally, British artillery and warships overwhelmed the
Chinese forces. As a result of the loss, the Chinese were
forced to capitulate both land and trading rights to the
British. In fact, as a result of the Opium Wars, the island
of Hong Kong would become a British colony until it was
returned to Chinese control in 2000.
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