Who is allowed to administer morphine

Knowing the facts and helping to unravel a few myths, will help you and your carers understand opioid medicines and therefore manage your pain effectively so you can get on with living as well as possible with your life-limiting illness.

Palliative care is an approach designed to improve quality of life for someone living with a life-limiting condition. It focuses on your needs, as well as those of your family and carers, and it can begin as soon as you have been diagnosed. Managing your pain is an important part of palliative care. Pain is an unpleasant sensation, suffering or distress. All pain hurts and can wear you down.

Pain can make you irritable, make it hard to sleep, reduce your appetite, and make it hard to be active and enjoy life.

Pain management starts with having a conversation with your health care professional, whether that be your GP, your specialist such as an oncologist or respiratory physician, or your palliative care team. It is essential that you are open and honest about your pain so it can be assessed and planned for, for you as an individual. To get a clear picture of your pain, your doctors and nurses will ask the following questions; based on SOCRATES mnemonic acronym often used in pain assessment.

Non-pharmacological ways in which to relieve your pain may be explored first such as heat packs, positioning, physiotherapy, alternative therapies etc. It may be that you have tried things yourself, it is helpful to communicate about whether or not these things have helped you to better direct the pain management plan.

Opioids are medicines that are prescribed for strong or severe pain that is no longer responding to medications of lesser strength. They come in different formulations such as tablets, patches or a liquid and your prescriber will discuss which one is best for you and your individual pain treatment. Opioids also have a role in managing severe diarrhoea and cough.

Your medical or nurse practitioner will most likely start you on an intermittent regime of an opioid to take as you need it within certain time parameters. You will need to keep a record of when you take the medication and its effect on your pain and any other side effects, so you can show this to your practitioner at your review.

It is essential that you contact them if you have any unwanted side effects to discuss as quickly as possible so an alternative can be sort for you. Also your community pharmacist is an important resource in medication management and you may want to discuss the medication with them as well.

Once you have a documented regime that shows you would benefit from a slow release opioid, your practitioner will provide you with a new regime. This slow release tablet may be taken once or twice a day or you may have a patch that needs to be changed every 3 or 7 days, dependent on your clinical need. You will still be able to take intermittent dosing as pain can still be a problem with your daily activities and it is essential that you can control it so you can continue living well with your disease.

It is very important that if you are needing more than 3 intermittent doses per day, that you contact your practitioner to revisit your slow release dose. Also remember that this type of medication cannot be crushed or broken into smaller parts. Your practitioner may prescribe other medications such as a weak analgesia like paracetamol which can complement opioid management or an adjuvant.

Adjuvants help with other types of pain such as neuropathic nerve or visceral organ , and can provide an umbrella effect with addressing all aspects of your individual experience of the pain.

Often adjuvants can help reduce the need to increase opioids and can provide a more steady state in your pain management experience. All medicines have two names: a generic name and a brand name. Each medicine has only one generic name, but if it is sold by more than one company it will have different brand names.

For example, the generic name is oxycodone and its trade name for the long acting formulation is Oxycontin and the short acting 5mg tablet is Endone and all doses 10mg and up are called Oxynorm. If you have any questions, ask them.

Write down your questions beforehand or when you think of them, and make sure you get the answers you need. Take your medicines regularly at the times prescribed or as close as possible to those times to get the maximum benefit from them. This delivery method works best for patients who have few remaining options to treat respiratory distress or for whom conventional breathing treatments are no longer effective.

In most patients, small oral dosages of morphine titrated toward relieving respiratory distress is very successful and well-tolerated. Sleepiness and lethargy : Morphine can cause some sedation initially, but this effect decreases within a few days. By easing pain and making breathing easier, opiates allow the patient to finally get some much-needed sleep. Once the patient is feeling more comfortable and rested, interest in normal life activities often increases.

Nausea : Nausea may initially occur but tends to wear off after a few days of taking morphine. In the meantime, nausea can be treated with a limited amount of additional medication. Less effective over time : Tolerance is possible but not often a problem when morphine is used to control pain. It is more likely that the disease has worsened over time, a change that results in increased pain. The hospice physician can increase dosage if and when pain increases.

Physicians generally start with low doses of morphine; if the pain increases, the dose can be increased. It's used for long-term pain. Sometimes you may take both a fast-acting morphine and a slow-release morphine to manage long term pain and sudden flares of pain that break through the long-acting medicine.

Fast-acting tablets are known by the brand name Sevredol. Slow acting capsules are also known as MXL or Zomorph. Morphine does not come as a skin patch. Sometimes people call their pain relief patch a "morphine patch". However these patches do not contain morphine but medicines which are very similar to morphine called fentanyl or buprenorphine.

Doses vary from person to person. Your dose will depend on how bad your pain is, how you've responded to previous painkillers and if you get any side effects. You can choose to take your morphine at any time of day but try to take it at the same time every day and space your doses evenly.

For example, if you take morphine twice a day and have your first dose at 8am, take your second dose at 8pm. It's important to swallow slow-release morphine tablets and capsules whole with a drink of water. Do not break, crush, chew or suck morphine slow-release tablets or capsules. If you do, the slow-release system will not work and the whole dose might get into your body in one go.

This could cause a potentially fatal overdose. Usually, you start on a low dose of morphine and this is increased slowly until your pain is well controlled. Once your pain is under control, talk to your doctor about swapping to slow-release morphine.

This may cut down the number of doses you have to take each day. When you stop taking morphine your dose will go down gradually, especially if you've been taking it for a long time. Depending on why you're taking morphine, you may only need to take it for a short time. For example, if you're in pain after an injury or operation, you may only need to take morphine for a few days or weeks at most.

You may need to take it for longer if you have a long-term condition such as back pain. If you forget to take a dose, check the information on the patient information leaflet inside the packaging or ask your pharmacist or doctor for advice on what to do.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine. This is not usually a problem but you could get unpleasant withdrawal symptoms if you stop taking it suddenly. If you want to stop taking morphine, talk to your doctor first.

Your dose can be reduced gradually so you do not get unpleasant withdrawal symptoms. If you have been taking morphine for more than a few weeks do not stop taking it without speaking to your doctor first.

If you've taken an accidental overdose you may feel very sleepy, sick or dizzy. You may also find it difficult to breathe. In serious cases you can become unconscious and may need emergency treatment in hospital. Get someone else to drive you or call for an ambulance.

It's safe to take morphine with paracetamol , ibuprofen or aspirin. Do not take codeine-containing painkillers that you can buy alongside prescribed morphine and prescribed codeine.

You will be more likely to get side effects. Some everyday painkillers that you can buy without prescription from pharmacies contain codeine, which is a similar medicine to morphine. Codeine-containing painkillers from pharmacies include co-codamol , Nurofen Plus and Solpadeine. Like all medicines, morphine can cause side effects in some people but many people have no side effects or only minor ones.

Common side effects happen in more than 1 in people. Talk to your doctor or pharmacist if the side effects bother you or do not go away:.

In rare cases, it's possible to have a serious allergic reaction anaphylaxis to morphine. These are not all the side effects of morphine. For a full list see the leaflet inside your medicines packet. Do not take any other medicines to treat the side effects of morphine without speaking to your pharmacist or doctor.

In early pregnancy, it's been linked to some problems for your unborn baby. If you take morphine at the end of pregnancy there's a risk that your newborn baby may get withdrawal symptoms or be born addicted to morphine.

However, it's important to treat pain in pregnancy. For some pregnant women with severe pain, morphine might be the best option. Your doctor is the best person to help you decide what's right for you and your baby. Morphine is not usually recommended if you're breastfeeding. Small amounts of morphine pass into breast milk and can cause breathing problems in the baby.

Speak to your doctor as they may be able to recommend a different painkiller. Some medicines and morphine interfere with each other and increase the chance that you will have side effects. It's not possible to say that complementary medicines are safe to take with morphine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines. Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

It works in the central nervous system and the brain to block pain signals to the rest of the body. It also reduces the anxiety and stress caused by pain. When morphine blocks the pain, there are other unwanted effects, for example, slow or shallow breathing.

It also slows down digestion, which is why morphine can cause constipation. Fast-acting morphine taken by mouth works in 30 to 60 minutes but it wears off after 4 to 6 hours. Slow-acting morphine taken by mouth can take a day or 2 to start working but the pain relief will last for longer. It's difficult to say how long morphine suppositories take to work, as it varies from person to person.

Yes, morphine is addictive. If you need to take it for a long time your body can become tolerant to it. That means you need higher doses to control your pain.