A person with their tongue out eats slow-release morphine pills.

Does Morphine Help With COPD? 

Morphine is an age-old medicine used to relieve pain though it has other uses too. In fact, it is sometimes used as a treatment for COPD. So, what exactly is morphine anyway? When might it be used for COPD? Here’s what to know.

Poppy origins

Around 10,000 years ago perhaps, some random person experimented with the plants that contained the poppy seeds. This person observed that the seeds contained a milky substance inside them. He or she, or some later person, observed the medicinal properties of the milk of the poppy seed.1

Various ancient texts mention this substance. Some of the earliest come from Mesopotamia around 3,500 B.C. Sometimes the plant was referred to as poppy seeds or simply poppy. Although, a more common term that evolved was opium. Its medicinal property was as a pain reliever. Once ingested, you felt no pain and had no fear of impending pain. You sensed a feeling of euphoria.1-2

Researchers today have no idea where the plant originated, although, they have observed evidence suggesting it was domesticated among early civilizations. The poppy may have been used for treating things like joint pain, childbirth, or toothaches. It was also effective for traumas, such as those that occurred in sports or war.1-2

Morphine

Poppy seeds were the original narcotic. In 1804, a German chemist named F.W.A. Sertürner performed experiments on opium. He isolated morphine as the active ingredient in opium responsible for pain relief. It was soon learned that morphine was ten times stronger than opium. Morphine was then derived from the poppy seed and used as a common analgesic during the 19th century. It was an effective pain reliever used during the American Civil War.1-3

Today, Morphine is still used for its analgesic properties. Interestingly, some recent studies show that morphine may be very helpful for those suffering from chronic breathlessness, which may occur in some people with severe COPD.4-5

How might morphine benefit people with COPD?

Morphine is a pain medicine. It is a narcotic. It is generally only used in emergency situations to treat pain. It is also used at the end of life for palliative care to create an aura of comfort. It is a very addictive medicine, so it is generally used sparingly. It can also depress your drive to breathe if given in large enough doses. It is for these reasons that many physicians are reluctant to use it, even for COPD.4

Some people with severe COPD have what is called refractory breathlessness. This is breathlessness that persists despite treatment with all the best COPD medicines. Studies seem to indicate that these patients might benefit the most from treatment with morphine.4

Recent study results

One study studied the effects of low doses, or sustained-release, morphine on 111 patients with COPD and refractory breathlessness. Some of the patients received 10 mg of regular, oral sustained-release morphine. The medicine was taken twice daily for four weeks. Other patients received a placebo, which is essentially a fake medicine. This is important to have something to compare the test results with.4

The study was concluded and published in the August 17, 2020 edition of the Journal of the American Medical Association (JAMA). It concluded that low dose, or oral sustained-release, morphine significantly reduced the feeling of breathlessness. This effect was obtained with no reports of side effects.4

More research

Another study looked at the effects of low doses of morphine on exertional breathlessness. This is where you become breathless even with minimal exertion. An example here would be people with COPD who have trouble doing simple tasks such as taking a shower or brushing their teeth. So, this is called exertional breathlessness.5

This study measured the effects of low doses of oral immediate-release morphine on exertional breathlessness. Twenty patients with severe COPD participated in this study. Some of the patients were given morphine, while others were given a placebo.5

The study was concluded and published in a 2017 issue of the European Respiratory Journal. It concluded that those taking low doses of morphine reported less breathlessness and had an increased tolerance for exertion.5

These and other studies, coupled with real-life experiences in the hospital setting, have inspired physicians and researchers. Morphine has now been added to many COPD guidelines for severe COPD coupled with refractory breathlessness.4

Concluding thoughts

Some physicians have long prescribed low doses of morphine for refractory breathlessness in the hospital setting. Other physicians have hesitated to prescribe morphine due to the risk that it might depress the drive to breathe. This inspired researchers to study the effects of low doses of morphine in various studies. Many of these studies, such as those described above, show that low doses of morphine may prove beneficial for people with COPD who also experience refractory or exertional breathlessness.

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