Ethex Morphine: History and its Medical Uses
Morphine (taken from the Greek god of dreams, Morpheus, for obvious reasons) was the first active alkaloid extracted from the opium poppy plant when it was discovered in Paderborn, Germany, by a German pharmacist, Friedrich Sertürner in 1804 and has now been around for more than 200 years. It was. first marketed as a drug to the general public by Sertürner and Company in 1817 as an analgesic, and also as a treatment for opium and alcohol addiction. Commercial production began in Darmstadt, Germany in 1827 by the pharmacy that was later to become the pharmaceutical company Merck, with morphine being one of their major products in the early part of their growth. It became more popular later, in 1857 due to the invention of the hypodermic needle.
It was later found that morphine was more addictive than opium, and its indiscriminate use during the American Civil War allegedly resulted in what came to be known as ‘the soldiers’ disease’ as most of the victims were soldiers wounded in battle or due to other related causes, though the subject has been mired in controversy as there were suggestions of the rumour being a fabrication. The phrase “soldier’s disease” was first documented in 1915 during the Great War or the First World War.
In 1874, diacetylmorphine (heroin) was developed from morphine by Bayer and introduced in the market in 1898. It was known to be at least 50-100% more effective than morphine.
Morphine came under the Harrison Narcotics Tax Act of 1914 and became a controlled substance in the United States resulting in its possession without prescription being made a criminal offense. Before oxycodone (1916) and the dihydromorphinone class of opioids (1920s), there was no other drug in the same league as morphine and heroin as synthetics were still several years away. In fact even today, morphine still has a demand that surpasses all prescription narcotics by habitual users.
It was in 1925 that the structural formula of morphine was determined, and in 2003, it was found that endogenous morphine occurred naturally in the human body with at least 30 years of speculation and observation because mu3 opiate receptor in human tissue apparently reacted only to morphine. The cells in the human body that are generated as a result of cancerous neuroblastoma have been found to contain trace amounts of endogenous morphine. The human body also produces endorphins called neuropeptides and has somewhat similar effects.
In clinical medicine, morphine is regarded as the de facto standard or benchmark, for analgesics that are used to relieve severe or agonizing pain. On the same lines as other opioids, such as oxycodone, hydromorphone, and diacetylmorphine (heroin), morphine acts directly on the central nervous system (CNS) to relieve pain. Unlike many other opioids, morphine is an opiate and is a natural product. Morphine has a high potential for addiction. It has been noted that the tolerance and psychological dependence on morphine develops rapidly, physiological dependence may take several months to develop.
Morphine is primarily used to treat pain, both acute and chronic. It is also used for pain caused by myocardial infarction, though there are concerns that use of morphine can increase the mortality rate in non-ST elevation myocardial infarction patients. And there are reports that morphine has been used in the treatment of the acute pulmonary edema in the past though a review in 2006 found little evidence to support this practice. Morphine has also been used for alleviation of labor pains. There are other uses of morphine: Reduction of symptoms of shortness of breath due to cancerous and noncancerous causes, alleviate mild dry cough and diarrhea: as a component in tincture of opium in pediatric patients: as an anxiolytic and antidepressant, though in the present time, its use is debatable.
Absorption and metabolism:
Morphine can be taken by mouth, per rectal, subcutaneous, intravenous, intrathecal or epidural, but intravenous injection is the most common and beneficial mode of administration. Due to a large proportion being broken down by the liver, roughly 50% of the dose taken orally reaches the central nervous system.
In the United Kingdom, morphine is listed as a Class A drug under the Misuse of Drugs Act 1971 and a Schedule 2 Controlled Drug under The Misuse of Drugs Regulations 2001.
In the United States, morphine is classified as a Schedule II drug under the Controlled Substances Act.
In Canada, morphine is classified as a Schedule I drug under the Controlled Drugs and Substances Act.
In Australia, morphine is classified as a Schedule 8 drug under the variously titled State and Territory Poisons Acts.
In the Netherlands, morphine is classified as a List 1 drug under the Opium Law.
In Japan, morphine is classified as a narcotic under the Narcotics and Psychotropics Control Act.
Internationally, morphine is a Schedule I drug under the Single Convention on Narcotic Drugs
In beginning 2009, FDA had written warning letters to prescribers and distributors about non-FDA-approved opiods which included the Roxanol, a brand of a concentrated form of oral morphine solution (20mg of morphine per milliliter of liquid). It is commonly used in hospice patients because the high concentration makes it easy to give to patients who have swallowing difficulties or have altered level of consciousness.
In August, 2009, the US Food and Drug Administration (FDA) has approved morphine sulfate and naltrexone hydrochloride extended-release capsules (Embeda manufactured by King Pharmaceuticals, Inc.) for once- or twice-daily use in the management of prolonged moderate-to-severe pain.