Introduction
Persistent pain is extremely common, and it affects many people all over the world. Pain is exceedingly frustrating, and it can result to financial impairment emotionally, vocationally, and physically. Those medications are aimed at reducing the intensity of pain, play an extremely essential role in managing symptoms, but they are supposed to be part of a management plan that focuses on reducing the disability and improving the quality of life. Opioids are now being used in treatment of severe pain. The role opioid drugs are well established in management of pain including surgery, and pain that are associated with terminal illness.
Opioids can be effective in the medium and short term, and they tend to provide improvement in cancer pains (Kettelman, P 1999). Opioids are not supposed to be used as sedatives, antidepressants or hypnotics. When one is, monitoring the effects of the opioid it is essential to identify the analgesic effects.
Morphine is an extremely powerful pain reliever which is derived from the poppy or opium plant. Morphine works well in relieving labor pain, and it also has few side effects as compared to other drugs with the similar function like pethidine. Morphine was the first active principle that was purified from a plant (Kettelman, P 1999). Morphine in medicine is regarded as “the gold standard” that is used to relieve severe pain and suffering. It acts directly to the central nervous system in helping to relieve pain. It has a great potential for tolerance, addiction, and its dependence psychologically develops remarkably quickly.
Morphine is usually used in treating chronic, and active severe pain. Morphine affects the body by docking with receptors on the cell surfaces. The receptors are removed from the surface once they come into contact with the morphine. They are usually drawn down to the cell which is a process called endocytosis. While in the cell, the receptors are then recycled or degraded back into the surface.
Pain is a dreadfully experience, and it can be the cause of nothing else matters to a person. According to some concerns, it is said that morphine can increase mortality (Kettelman, P 1999). Traditionally morphine was used for treating “acute pulmonary edema.” Immediate use of morphine help in reducing symptoms like loss of breath due to non cancer and cancer causes.
When it is administered through intramuscular, intravenous, or subcutaneous its analgesia duration is about three to four hours. When it is administered through the mouth, its duration is about three to six hours. In Slovenia, Austria, and Bulgaria, it is normally used to slow the release formulations of opiate substitution therapy for those addicts who are not able to tolerate the side effects of using buprenorphine or methadone. Morphine is normally used in controlling pain to patients with cancer.
Background
Morphine was discovered 200 years ago, and it is usually available in different formulations. These formulations are oral, rectal, and parenteral. The oral form of the drug is available in a variety of preparation from sustained release to immediate release. This allows the drug to be titrated to the response of the patient. The oral form is normally recommended because it is easy to administer, and it is also convenient to use. Cancer pain usually stems from the tumor (Kettelman, P 1999).
Tumor normally causes pain that is attributed to the invasion of the bone, nervous structures, soft tissue, and muscles. Rapid growth of tumor can cause acute pain. Thorough examination needs to be carried out so that to establish the cause of the pain, and this will help in managing the pain successfully. Managing pain does not only focus on reducing the intensity of the pain, but it should also focus on improving the physical, vocational, emotional, and social wellbeing of a person. Cancer is the most terrible diagnosis that anybody can get because of its inevitable futility. Pain is the most fearsome symptom of cancer therefore; it is very important to treat pain.
Almost a quarter of cancer patients usually die in pain. Patients who are suffering from cancer experience differing intensities of pain and they also respond differently to analgesic. Studies show 33 percent of patients who get active treatment of cancer usually experience incredibly severe cancer related pain (Fukshansky, M et al 2005). Reports show that there is under treatment of pain related to cancer where 50 percent of patients get inadequate treatment for controlling pain and 30 percent top do get appropriate management of the pain (Fukshansky, M et al 2005).
Cancer pain is complex, and providing a patient with just one analgesic is not enough to ease all the pain that the patient is undergoing. There are very many types of medications available for treatment of pain in cancer patients, but the most preferable drug for controlling pain in cancer patients is morphine. Morphine is normally used in very many clinical situations like, treatment of patients with acute pain, in treatment of patients who have poor pain control needs, and optimizing opioid therapy in order to prevent incident pain that is associated to bone metastases. This review is going to provide an overview of the advantages of using Morphine in pain control as compared to other pain medications in terminal cancer patients.
Advantages of morphine
Morphine binds at the opioid receptors which are located at the spinal cord and the brain. This binding process modifies the biochemical reactions which occur in responding to pain and it interferes with the conduction of the pain stimuli and raises the pain threshold of the body (Susan, B 2008).
Most patients with cancer usually suffer unnecessarily. The reason as to why these patients suffer is because they have a wrong understanding of morphine as they believe that it is used as a comforter for people dying people. This is the wrong understanding of morphine as it is a legitimate pain control which tends to improve a person’s quality of life (Weschules, D. Et al.2006).
Most people hold on the belief that Opioid is used to hasten death, but this is a wrong belief. People tend to reject morphine because they think that professionals use it for the last resort. Because one does not want to die, they end up rejecting it and then they face the consequence of the pain that they are experiencing. According to Susan, B (2008) he states that patients at all stages of cancer can use Morphine if the pain is sufficient.
Morphine is of great advantage to the patient with severe pain because it changes the emotional status of the patient, and the patient who is taking this drug does not feel the pain as being severe. Because of this unique ability of creating indifference in pain, it makes it a very powerful analgesic (Kettelman, P 1999).
Morphine is normally considered as the first choice in treating severe cancer pain. The advantage of morphine over other medication in treatment of pain in cancer patients is that its side effects can be easily treated. The administration of morphine takes different forms unlike other forms of treatment in pain control. The selected route for its administration usually depends on how sever the pain is, the ability of the patient to swallow, the absence or presence of vomiting, nausea, and the availability of the muscle mass (Weschules, D. Et al.2006).
When the bloodstream absorbs this drug from gastro intestinal tract, it travels very fast to the liver where it is metabolized. When the drug is administered orally, higher doses need to be given because fifty percent of the drug can be inactivated before it even reaches all the rest of the body. Those cancer patients who receive intrathecal infusion of morphine have better relief pain within four weeks. Those patients who have been treated using other convectional medication do not perform better.
The advantage of morphine is that its side effects do not lust for long unlike other medication for pain control. Sedation is usually felt when the treatment is starting, but it gets resolves a few days later. Nausea and vomiting also occurs when the patient takes morphine orally, but this is usually easy to control.
Most of the side effects of morphine are normally resolved after the patient continues using the drug (Weschules, D. Et al. 2006). Morphine is the main pharmacologic therapy for pain syndrome related to cancer. When a doctor is working with morphine, he or she is supposed not to give more than what is needed for relieving pain. Because the response of morphine varies from one patient to the other, it is indispensable to assess the pain of each individual and make the adjustment to the dosage of the drug so as to meet the needs.
Conclusion
Morphine is normally used in very many clinical situations like, treatment of patients with acute pain, in treatment of patients who have poor pain control needs, and optimizing opioid therapy in order to prevent incident pain that is associated to bone metastases. There are very many types of medications available for treatment of pain in cancer patients, but the most preferable drug for controlling pain in cancer patients is morphine. People are supposed to change their attitude about the use of morphine and know that it is the best recommended medication for relieving pain mostly to cancer patient.
The negative effects of this remedy are not as rigorous as what people say and therefore, people should stop rejecting it. Morphine is not used by specialists to hasten death, or as a final alternative but it is very helpful in relieving pain. Morphine does not suggest death, but when it is used properly it helps in promoting the quality of life of the patient by allowing the patient to function well. In order to have quality improvement of life, it is essential to prescribe the correct amount of morphine.
Reference
Are, M Burton, A & Fukshansky, M (2005). The role of opioid in cancer pain management World institute of pain 5 (1)
Justins, G & Lancet, D () cancer pain: management retrieved from http://ehis.ebscohost.com/eds/detail?sid=4da8c48c-f949-400c-80aa-74a8a0114170%40sessionmgr14&vid=1&hid=2&bdata=JnNpdGU9ZWRzLWxpdmU%3d
Susan, B (2008) Morphine retrieved from http://ehis.ebscohost.com/eds/detail?sid=7a32c9b9-6c26-44d9-aead-1ae6e38ca626%40sessionmgr110&vid=1&hid=103&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=eda&AN=4941150
Kettelman, P (1999). Why give more morphine to a dying patient nursing journal 29 (11)
Weschules, D. Et al. (2006). Toward Evidence-Based Prescribing at End of Life American Academy of Pain Medicine, (7) 4
