Morphine is a Schedule II controlled substance, which means that it has accepted medical uses and a high risk for people developing unhealthy use patterns. Brand names for morphine include Avinza, Kadian, Morphabond, MS Contin, Oramorph SR, and Roxanol-T. Most workplaces rely on SAMHSA’s 5-panel urine test which can detect the presence of morphine used within the last four days. Knowing how long the effects of morphine last, can help prevent accidental overdose or dangerous interactions with other medications or alcohol.
How Long Does It Take to Feel Effects?
Morphine is prescribed in several different forms, including a liquid solution and extended-release tablets and capsules. The timing of dosage is important for it to reach therapeutic levels but not a level that could cause an overdose. Urine: Up to 4 days Saliva: Up to 3 days Hair: Up to 90 days Different formulations of morphine have different onset times and durations:
Extended-release morphine delivers the dosage in stages, the effects lasting for 12–24 hoursInstant-release morphine’s effects begin within 15 to 60 minutes and last 4 to 6 hours
Other effects of morphine besides pain suppression include:
Euphoria Depressing breathing Constricted pupils Reducing gastrointestinal activity Drowsiness Dysphoria Altered mental status
The body becomes tolerant when morphine is used over time and dosage may need to be adjusted to provide the desired effects. Morphine also leads to dependence and the body can have withdrawal symptoms if it is stopped. For this reason, it is important to follow the schedule provided by your doctor when it is decided to stop morphine.
How Long Does Morphine Last?
Morphine has a short half-life, with half of it metabolized in 1.5 to 7 hours. Most of a single dose of morphine is eliminated in the urine within 72 hours. Morphine is broken down in the body by glucuronidation and sulfation. According to a 2014 study, Morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) are the main metabolites of morphine that may also show up on a drug test. Brand name products such as MS Contin can also contain lactose, polysorbate, black iron oxide, and colored dyes. If the drug test yields a positive test result, a physician at a medical review office will review the results and you will be contacted to determine if there is a good reason. If the results are negative, employers are told by the medical reviewer within 24 hours. Types of tests that can be used to detect morphine include blood, urine, hair, and saliva. There are not really good breath tests for detecting morphine. Hair and blood tests are used less often.
Urine
Morphine can show up on a urine test for up to four days after use. Urinalysis is the most commonly used method for testing for morphine and typically involves the enzyme-multiplied immune test. If morphine or any of the tested metabolites are present in the urine specimen in sufficient amounts, a visible colored line will show up in the test line region of the drug strip. The urine sample you provide will go through a secure chain of custody to end up at a testing laboratory to be screened, often with the SAMHSA 5 panel. The specimen will be tested for adulterants and the presence of the drug. The presence of the drug will be confirmed by a second test using gas chromatography-mass spectrometry or liquid chromatography.
Blood
Morphine can show also up on a blood test up to 3 days after use, but as these tests are more invasive and expensive, they are not commonly used in employment drug screenings.
Saliva
Morphine can show up on a saliva test about 3 days after use. The morphine detected in saliva is usually in the process of circulating through the blood, which is why these detection times are similar. That said, saliva-based drug testing is not approved by the FDA or SAMHSA for Federal Mandated Drug Testing and so is not likely to be used.
Hair
Morphine can show up on a hair follicle test for up to 90 days after use.
False Positive Testing
Most urine drug tests look for morphine. As a result, morphine use can easily be detected. That said, while urine drug tests are simple and affordable, they can return false-positive results for opiates like morphine. Poppy seeds can cause a false-positive test result for opiates. While only present in trace amounts, poppy seeds do contain enough codeine and morphine to show up on enzyme immunoassay (EIA) tests that are often used in workplace and medical drug screenings. Additionally, certain medications, including allergy drugs containing diphenhydramine and doxylamine and quinolone antibiotics such as levofloxacin and ofloxacin can cause a false-positive opiate screening. As a result, testing to identify specific drugs, rather than classes of drugs, is needed to confirm a positive urine drug screen for morphine.
Factors That Affect Detection Time
Morphine is metabolized at different rates and can vary in how long it takes to show up in urine based on various factors.
Dosage
The more morphine present in the body, the longer it will take to be eliminated.
Other Medications
If the pathways involved in opioid metabolism are busy breaking down other substances in the body, it will also take longer for the drug to leave the body.
Age
Older patients metabolize morphine more slowly.
Medical Conditions
People with hepatic or renal impairments may also eliminate morphine more slowly. According to a 2009 review, there is no difference in metabolism amongst sexes.
How to Get Morphine Out of Your System
Morphine is broken down by the body and excreted in the urine, with most of a single dose eliminated after 72 hours. However, with longer use or heavier doses, the time it takes to clear out of the body can be longer. Exercising, drinking a lot of water, and other myths people might have about how to flush your system before a drug test are likely not going to work. The only way to get morphine out of your system is to stop taking the drug and allow your body time to metabolize and eliminate it.
Symptoms of Overdose
A morphine overdose can happen when it interacts with other medications, when doses are given too close together, or too much morphine is taken. Never crush or cut an extended-release tablet or capsule as that may deliver too much morphine at one time. Some symptoms of morphine overdose include:
Slow, shallow, or irregular breathingSleepinessLoss of consciousnessLimp or weak musclesCold, clammy skinSmall pupilsSlow or stopped heartbeatBlurred visionNauseaFainting
Bystander training to reverse an opiate overdose with naloxone is available in your area. By administering naloxone, sometimes referred to by the brand name Narcan, someone experiencing a morphine overdose may regain consciousness and the ability to breathe. They may also begin to experience withdrawal symptoms. Taking additional opiates at this point will cause a second overdose and is not recommended. Naloxone is available over the counter many places and from the local health department.
Interactions to Avoid
Morphine depresses the respiratory system and slows the heart rate. As a 2018 review explains, when morphine is combined with these drugs, there is an increased risk of low blood pressure, sedation, and potentially fatal respiratory depression:
Benzodiazepines and other CNS depressants Anesthetics Barbiturates Tranquilizers Antipsychotics Other opioids Alcohol Antihistamines Baclofen Cimetidine P-glycoprotein inhibitors such as quinidine
A previous history of breathing problems, including asthma and chronic obstructive pulmonary disease (COPD), are reasons to be even more cautious with the use of morphine.
Getting Help
Symptoms of morphine withdrawal include muscle aches, insomnia, anxiety, nausea, and vomiting, and can begin as early as six hours after the last dose. Some people compare the symptoms to those of the flu. Symptom severity varies according to the frequency of use, tolerance, and overall health and metabolism. The acute physical effects of morphine withdrawal last for three to five days, but the psychological effects may persist for several weeks. Persisting patterns of binge and withdrawal can exacerbate problematic substance use. There are many treatments available, including medication-assisted treatment (MATs) with methadone or buprenorphine, which can help with withdrawal. A 2017 review details the efficacy of MAT in the treatment of opioid use disorder. If you are pregnant or plan to become pregnant, discuss this with your doctor as there is a risk of dependence and withdrawal in newborns of mothers who have prolonged use of morphine. Don’t breastfeed while you are taking morphine. According to the NIH, morphine will pass through your milk to your child and your child can also become dependent.
