Does morphine make someone die sooner?
No, morphine does not usually make someone die sooner when it is prescribed and used carefully for pain or breathlessness in palliative care.
No, morphine does not usually make someone die sooner when it is prescribed and used carefully for pain or breathlessness in palliative care. Morphine is used because these symptoms can be frightening and exhausting. The aim is comfort, not to cause death.
People often ask this because morphine may be started, or the dose may go up, when someone is already very unwell. The timing can make it look as if morphine caused the decline. Often the illness itself is changing, and the medicine is being adjusted because the person has more pain, breathlessness or distress.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Why morphine is used near the end of life
Morphine is an opioid medicine. In palliative care it may be used for severe pain. It can also help breathlessness, even when the person is not in pain.
Palliative Care Australia explains that opioids are used to improve comfort and quality of life. Its opioid resource directly addresses the fear that morphine hastens death and says that relieving pain changes quality of life, not the length of life.
Morphine can be given by mouth, under the skin, by injection, through a patch-like plan using another opioid, or through a syringe driver. The right option depends on the person's symptoms, swallowing, kidney function, alertness, previous opioid use and goals of care.
Why the person may seem worse after morphine starts
A person may become sleepier after morphine is started or increased. This can be a short-term side effect, especially in the first few days or after a dose change. Drowsiness can also happen because the person is closer to death, has an infection, has kidney or liver problems, is dehydrated, has high calcium, or is taking other medicines that add to sleepiness.
This is why changes should be reviewed. Tell the palliative care team if the person is much harder to wake than expected, more confused, twitching, breathing very slowly, or you feel something is not right.
What careful prescribing means
Careful prescribing means the team starts with the person's situation, not with a fixed dose for everyone. They look at what symptom is being treated, what medicines the person already takes, how frail they are, and whether their kidneys or liver are working well.
The dose may be changed over time. This is not proof that the medicine has stopped working or that death is being brought forward. Pain and breathlessness can change as illness changes. Some people need very small doses. Others who have taken opioids for a long time may need larger doses because their body is used to them.
You should not increase, reduce or stop morphine unless the person's own doctor, nurse practitioner or palliative care team has told you to. If the person has a home medicine plan, follow that plan and record any extra doses as instructed.
When morphine can be dangerous
Morphine can cause serious harm if the wrong person takes it, if too much is taken, if doses are given too close together, or if it is mixed with other sedating medicines without clinical advice. Healthdirect warns that opioid overdose can cause life-threatening breathing problems.
Keep morphine and other opioids out of reach of children and visitors. Do not share medicines between people. Return unused medicines to a pharmacy when the team says they are no longer needed.
When to get help now
Contact the person's palliative care team, nurse or doctor urgently if:
- the person is much more sleepy or confused than expected after a medicine change
- their pain or breathlessness is not settling despite the written plan
- you are unsure whether to give another dose
- you think the wrong medicine or wrong dose may have been given
Call 000 if the person is not breathing, cannot be woken, has signs of a serious overdose, or there is a life-threatening emergency. If the person is expected to die at home and has an agreed plan, use that plan and the after-hours number you were given.
You may also want to read
- Why did the morphine dose suddenly increase?
- Why are they sleepier after medication?
- How can something that slows breathing be safe in somebody who is already dying?
- When should I call 000 for someone receiving palliative care?