Morphine addiction.

I've had two close friends who've died from heroin overdoses, so I can only speak from the perspective of... well... a friend. I'm involved in two networks to help heroin addicts get back on their feet. So for somebody who hasn't been a victim I think I'm pretty well informed.

1) So I've got a few questions about being addicted and withdrawals that i didn't find too easily. (my google fu sucks)

It is very hard to find information on it that isn't tainted by the "war on drugs". I suggest finding "harm-reduction" networks in USA who can direct you to rehabilitation staff, who themselves are ex addicts. I think you'll get the most honest no-bullshit account from them.

On withdrawals. I think without being a victim yourself, it's close to impossible to explain how horrific it is. So I won't. It's just very bad to see.

2) Can someone in a fight with both adrenaline and morphine in their system be able to take large amounts on nonfatal damage?

Yes. But I'm not sure about the adrenaline. I think they're more likely to have a calm psycho-killer sort of way of fighting.

3) Can people be more aggressive while on the drug?

It depends what you mean with aggressive. They become pretty emotionless and cold. So they become capable of doing pretty horrific things. But I think, while high they're about as relaxed about life as it is possible to be. Take a bunch of Xanax or Codeine and see how aggressive you become. They'll need a pretty good reason to attack anyone.

4) What are some common apparent symptoms of being addicted?


There's a looooong list. The big difference is when they're on or off it. Droopy heroin face and very skinny being the most apparent long term symptom regardless. When they're on it, slurred speech and droopy eyelids and sudden moments of freezing up and a complete inability to understand how obvious it is to the rest of the world that they're high. I've seen a friend with her whole cigarette being nothing but a long grey column of ash. "Hey, what happened to my cigarette?"

When they're off it they have a lot of anxiety. Not just about being addicted, but any shit regardless how insignificant. There's also a lot of bullshit justifications for doing heroin going on.... that just boggle the mind.

http://en.wikipedia.org/wiki/Heroin_withdrawal


5) Could being taken off the drug cause a resurgence of cowardice?

I'm not sure what you mean?

6) If the drug was being taken for legitimate purposes (lots of injuries that didn't heal right) could being taken off the drug cause any side effects besides normal withdrawal symptoms?

Why would they have anything but the normal withdrawal symptoms?

What Dr. Z said. Morphine isn't a rage inducing drug; it's not exactly a muscle relaxer, though. Morphine stops the nerves from sending pain signals to the brain, which means someone with a large quantity in their body might be taking serious damage, but not registering it. (The nerve effect is why so many people itch when given the drug for medicinal reasons.) It can also lower testosterone , IIRC, so the whole rage fighting thing is unlikely.

But remember that morphine burns through QUICK. Your guy would need an almost constant supply to keep up the effects.

I've never used it personally, nor did I deal with long term users but have prescribed a lot of it for post op pain. In my experience about a third of people don't get adequate pain relief and can even become agitated on it despite that we don't know why. I likened it to alcohol in that some people are angry drunks and others just sit in a corner and laugh. Everyone's biochemistry is slightly different. I have been on darvon and even oxycontin when I had a broken hip and 5 broken vertebrae due to a renal disease, not trauma. I hated the stuff. I never experienced anything remotely pleasant from it and it gave me the most horrendous constipation. Coming off a drug often has opposite it's typical side effects. Sedatives tend to reduce sensation so coming off them tends to result in a sort of sensory overload manifesting in agitation from light and sound and touch. It also would be common to have diarrhea once the slowed gut motility wears off.

If I remember correctly, Coloradoguy is an Intensive Care Specialist and Neurofizz is a neurosurgeon, they'd be good ones to talk to.

Actually if they are truly using it medicinally and not for recreation they probably won't have the typical withdrawl when stopping it, merely a resumption of the pain that they were treating. Read about Larry Flynt and his heroin use. He had no withdrawl when he finally had the surgury to cut the nerves that were causing his pain and therefore stopped the heroin as well. He is the classic example of using an illegal drug in a truly medicinal fashion.

Nivarion said:

Thanks drZ. A couple more questions.

Does morphine reduce or override the flight of flight? Or would it be less likely to be triggered? I mean more likely to be drawn into a fight or just kill their problems. Uh, like before he was taking it, he'd run away from situation A to avoid being hurt, but while on it would just charge right into A with out really thinking about it. And now that he's off it again, A scares him off again.

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I think you need to decide how bad it is for your character. If his abuse is mild and manageable there's no reason that he behaves in a way that is different than what he normally would. He might be less careful and less afraid of doing stuff his sober brain would avoid.

I should say that my examples are from people who are extremely far gone.

Nivarion said:

If a opiate addict were working out regularly and eating normal amounts, would they be able to maintain a high muscle mass? Would it be any more difficult than if they weren't on them?

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Maybe a doctor should answer this. But opiates messes with your sense of hunger. So yes, if he eats normal amounts he'd be fine. But he'd probably need to force it down his throat. So he might opt for more dense food like protein shakes and gainers. Stuff that's easy to get down his gob.

I don't think morphine messes with your muscles. But a major part of maintaining muscle mass is motivation. People on opiates tend not to be the most driven people out there.

GeorgeK said:

Actually if they are truly using it medicinally and not for recreation they probably won't have the typical withdrawl when stopping it, merely a resumption of the pain that they were treating.

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Not necessarily.

My (now deceased) uncle was a WWII amputee. Morphine was pretty much all they used to control his pain in the beginning because it was what they had on hand and they didn't expect him to live long enough for addiction to become an issue.

Maybe they gave him unusually high doses or something, but he spent the next 50 years "allergic" to opiate pain killers. (That's what he'd tell doctors/hospitals to explain why he didn't want to be prescribed opiates for pain instead of telling them he had been addicted to the stuff.) He never used it recreationally, or ever again after the medics stopped his drip at the VA hospital in the 40's.

I can't answer your questions directly but I'm here to offer you something that might help expand your writing.

I have had oodles of surgeries on my bowels and I had morphine for the pain-killer. It made me tired, drifty, and was hard to focus. I remember the warm prickly feeling in my chest after I pushed the button for more pain killers to go through me. It felt sort of like pins & needles, your foot falling asleep. Only warmer. It was kind of nice.

So at any rate, for me, that was the actual sensation of "taking" Morphine, if that helps at all.

Cyia said:

My (now deceased) uncle was a WWII amputee. Morphine was pretty much all they used to control his pain in the beginning because it was what they had on hand and they didn't expect him to live long enough for addiction to become an issue.

Maybe they gave him unusually high doses or something, ....

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Much of what we now understand about the use of morphine and addicting drugs has its basis in what was learned in and after WWII as a result of what happened to people like your uncle. The doses that they were giving people back then were way way higher than standard of care would dictate today. What they did back then is doses far beyond medicinal levels today. In the D-Day invasion they wanted the wounded to appear dead so as to not distract those who were still fighting.

Yes. Warmth goes along with it.

Nivarion - there is a difference between opiates injected for pain control and opiates taken for recreational purposes.

I don't remember any "warmth" - just the pain fading away on one occasion, and a really blissful floaty feeling on another.

if you have a morphine pump, the near-constant level prevents the rollercoaster pain/relief ride.

ADDING:
I've seen a lot of morphine injected for ski injuries, and no one reported a feeling of warmth, just a slight 'floaty' feeling or moderate pain relief. The quantity was extremely limited (seriously 10mg is NOT enough for a 250 lb man with a fractures humerus!).

I've written articles about opiates side effects and withdrawal symptoms, and specifically about heroin side effects and withdrawal symptoms.

Opiate effects:
Opiates are downer drugs - after few minutes of initial euphory they make you sleepy and give a feeling of a calmness and pleasure. Intravenous heroin have effect within 10 seconds, snorted in 15 minutes, ingested morphine in more than 30 minutes...

Side effects:
In the first week of repeating use, common side effects are nausea, vomiting, faintness, poor appetite, constipation, itchy skin. After a week, a tolerance develops to most side effects except to constipation. So, it's quite likely a morphine/heroine addict will seek for laxatives. Typical symptom of a morphin/heroin addict are pin-sized pupils. All these are anti-adrenalin effects (adrenalin makes you fight, morphine just makes you calm - no desire to make troubles...not necessary cowardice)

When opiates are combined with alcohol, they may cause serious respiratory depression (a common cause of death).

Withdrawal symptoms may appear a day after a sudden drop of the drug and are just the opposite of the calmness: anxiety, depression >> suicidal thoughts...craving for the drug, for which an addict needs money >> selling things, robbery...So, it is a desire for the drug, which can eventually make someone violent, not the drug itself.

Withdrawal symptoms in controlled use are usually less apparent or absent, since a patient is getting off the drug slowly.

Morphine witdrawal symptoms typically last about a week, but can last much longer. Later, even seing a random tablet or other thing related to drugs can trigger a strong desire for a drug.

Doctors or other medical personel who have access to morphine may get addicted. They usually use tablets.. for a long time before anyone suspects anything.

People who buy opiates on streets usually use heroin, not morphine - they inject or snort it. They may have punctuation marks and darkened (inflamed) veins on forearms. By sharing needles they may acquire hepatitis B or C or AIDS. By sharing snorting and smoking tools they may acquire tuberculosis.

A long-term addict may look skinny (poor appetite) with bad hygiene, dirty clothes, unshaved, messy hair, he/she might ask for money on the street or in the store...

Maintaing a muscle mass could be a problem because of low appetite and constipation, and hence avoiding eating. Also, an opiate addict will not likely be physically active.