Morphine (Encyclopedia of Drugs and Addictive Substances)
- How Is It Taken?
- Terri Schiavo
- Effects on the Body
- Treatment for Habitual Users
- Morphine Chronology
- For More Information
What Kind of Drug Is It?
Morphine is a natural product of the opium poppy plant. Of the many mind-altering compounds in the opium poppy, morphine is the strongest. The drug has many important medical uses, all having to do with pain control. It is never used to treat emotional or psychological problems.
For many people recovering from painful surgerynd for even more people facing the daily agony of end-stage cancerorphine can dramatically improve their quality of life. The drug, called an , has been used for pain relief for many years, in many different cultures worldwide.
When prescribed for a patient by a physician, morphine can help speed recovery from operations, ease the pain and trauma of childbirth, and give dying people relief from incurable pain. When used illegally as a recreational drug solely to get high, morphine is highly addictive with many unpleasant side effects. When purchased on the street, it is usually found in the form of heroin, a substance that turns to morphine in the brain. (An entry on heroin is available in this encyclopedia.)
Whether used legally or illegally, morphine is a very dangerous drug. Overdoses can cause fatal breathing problems. Even those who use it for pain relief can develop a dependence or physical need for the drug. Doctors tend to be very conservative when they prescribe it for pain because they are aware of its risks and drawbacks. Since the beginning of the twenty-first century, patients' rights groups have urged the medical community to use morphine more freely to control pain. They believe that patients in severe pain would be more likely to contemplate or commit suicide if they were unable to use the drug.
Morphine is derived from a flowering poppy called Papaver somniferum. This plant can grow in many environments, but it thrives in a soil that contains some sand and loam, in higher elevations with cooler temperatures. Opium poppies were first grown by people
6,000 years ago in the area that is now Iran and Iraq. A manuscript from the ancient Egyptian city of Thebes, dating to 1552 BCE, mentions opium as a cure for more than 700 illnesses.
From Plant to Drug
Although the leaves and stems of the opium poppy plant also contain opiates, it is the sticky sap in the bulbs that has the most strength. The bulbs begin to ripen after the flower petals fall. As the bulbs ripen, skilled farmers cut them, and the sap flows out. Once collected, the sap is dissolved in boiling water. The twigs and other plant material float to the surface, and the boiled opium is strained. It is then cooked a second time, this time to remove the water. Once the water has evaporated as steam, what remains is a putty-like substance called "smoking opium." After this simple process, users sometimes smoke or eat the opium to get high.
More commonly, though, the cooked opium goes through another chemical process. Again it is boiled, this time with lime. The lime converts the opium from a non-water soluble morphine into the water-soluble calcium morphenate. Ammonium chloride is added to the solution, and this causes the morphine to settle to the bottom of the cooking pot. The solution is poured through a straining cloth, and what remains is chunks of morphine that are dried in the sun. Legally, these morphine "bricks" are processed into prescription painkillers. Illegally, they are smuggled into laboratories and turned into heroin.
None of this chemistry was known to opium farmers in the era prior to modern medicine. In the Middle Ages (c. 500. 1500), opium was mixed with wine or other alcohol and called "laudanum." Crude opium was also smoked, particularly after the introduction of pipes from the Americas after Columbus (1451506) reached the New World in 1492. When opium smoking became widespread in Asiand particularly in Chinahe destructive and habit-forming effects of the drug began to be revealed.
In 1803 German chemist Friedrich Sertürner (1783841) experimented with opium and isolated morphine for the first time. He named his discovery after the Greek god Morpheus, who is often depicted in ancient statues sleeping among opium poppies. Within thirty years of Sertürner's discovery, it was possible to buy medicines with morphine from any store that sold remedies. Both morphine and opium cost less than alcohol, and the substances were abused by famous and common people alike. The users of morphine and opium-laced medicines were aware of the dangers. As early as 1821 author Thomas de Quincy wrote Confessions of an English Opium Eater, describing his personal experiences of addiction and drug-induced mental breakdown.
Morphine, a painkiller that can be dissolved in water, came to the forefront in 1848, when an inventor perfected the hypodermic needle. This allowed the substance to be injected right into a vein, producing pain relief (and euphoriaPronounced yu-FOR-ee-yuh; a state of extreme happiness and enhanced well-being; the opposite of dysphoria.) in minutes. Surgeons welcomed this new tool, since it enabled them to perform pain-free operations. But the medical community quickly learned that morphine was habit-forming. In his book Illegal Drugs: A Complete Guide to Their History, Chemistry,
Use and Abuse, Paul M. Gahlinger estimates that 400,000 soldiers became addicted to morphine during the American Civil War (1861865). Morphine addiction was so common among returning veterans that it was called "the soldiers' disease."
Discovery of Heroin
Doctors and chemists continued to experiment with morphine, hoping to create a product that would be less habitforming but would still control pain. Codeine was isolated in 1832. It was not as strong as morphine but was used in cough formulas and diarrhea medications. Soon it was found to be addictive as well. Another experiment on the morphine compound occurred in 1874, when British chemist Alder Wright created diacetylmorphine (DIE-uh-SEE-tuhl-MOR-feen), marketed as heroin.
With the introduction of heroin, morphine users and opium smokers hoped they had found a cure for their addictions. Many tried heroin to wean themselves off the other substances. In doing so, they traded a bad addiction for an even worse one. By that time, over-the-counter medicines containing codeine, morphine, heroin, and cannabis (marijuana) could be bought for problems as varied as toothaches, headaches, and fussy babies. (Entries for codeine and marijuana are available in this encyclopedia.) At that time, people did not realize the dangers of using such products.
Dealing with the Growing Abuse
China had long struggled with large numbers of opium addicts. As Chinese immigrants came to the United States to work, some brought the habit with them. By the late 1800s, almost every major city in the United States had at least 1 opium "den"; New York had more than 300. Opium dens were darkly lit establishments where people went to smoke opium. Many dens had beds, boards, or sofas upon which people could recline while experiencing the effects of the drug.
On February 1, 1909, China and the United States led a meeting called the International Opium Commission. Eleven other countries participated. Three years later, a convention in the Netherlands produced the first international agreement on the regulation of specially opium and heroin. Gahlinger wrote: "This began a process whereby the United States took a global leadership in controlling the international narcotics trade, even while its own domestic use of addictive drugs was rampant. One hundred years later, this situation has not changed."
The Harrison Narcotics Act of 1914 made it illegal to sell medicines containing heroin, morphine, or opium without labels warning of the presence of the drug in the product. In 1926 heroin was made completely illegal. Morphine remained legal but only when prescribed by a doctor.
The twentieth century was marked by enormous progress in surgery, medications, and treatments of all sorts of diseases. Scientists
developed syntheticMade in a laboratory. painkillers based on the properties of morphine, such as oxycodone and fentanyl. However, they made no progress in removing the habit-forming effects of the substances. (Entries on oxycodone and fentanyl are available in this encyclopedia.) Morphine is still widely used in hospital settings and is prescribed as pills and liquids. It is also available in a pump implanted in the body, for use in the most stubborn, ongoing, and incurable pain. Except in the case of surgery, doctors use morphine as a drug of "last resort," after all other painkillers have failed. It is most often used when a patient is dying. At the last stage of life, the fact that morphine is addictive is no longer significant.
What Is It Made Of?
Morphine is an alkaloid, the chemical class to which many drugs belong. It is also an organic product, meaning that it is derived from a plant. The process of extracting morphine from opium is so simple that farmers can do it alongside their fields, with few other tools than cooking pots, lime (an ingredient in fertilizers), and ammonium chloride (also found in fertilizers). In its basic form, the morphine alkaloid is not soluble in water. Once it has been treated with lime and ammonium chloride, however, it becomes the water-soluble compound calcium morphenate. Further treatments produce morphine sulfate, morphine hydrochloride, and morphine. All of these are used in medicines.
After having gone through chemical processing, morphine salts appear as a bitter white powder. Some people take this powder by mouth, while others snort it or dissolve it in water and inject it. Morphine products are not as fat soluble as heroin. A highly fatsoluble drug like heroin enters the bloodstream quicker and moves to the brain faster, no matter how it is taken. As such, morphine products do not work as quickly to produce the intense high that is experienced with heroin use. Injected morphine does work quickly, in about five to ten minutes, whereas heroin works almost immediately.
The vast majority of legal morphine is converted to codeine, a milder painkiller and cough suppressant used in great quantities worldwide. The remainder of legal morphine is processed as a painkiller. More than 1,000 tons of morphine are produced legally every year, from poppies grown on government-regulated farms in India, Turkey, and the Australian province of Tasmania. Illegal opium production is widespread in the highlands of Burma, Laos, Vietnam, Thailand, Pakistan, Afghanistan, Colombia, Mexico, and Lebanon.
How Is It Taken?
Prescription morphine comes in many forms. As morphine sulfate and morphine hydrochloride, it is a liquid injected into veins. As Duramorph, it is a liquid injected into the fluid surrounding the spine. This type of injection is called an epidural. Duramorph is used in childbirth and some forms of surgery that can be performed while a patient is awake. Morphine pills of various strengths are also available and are prescribed for cancer pain, back pain, recovery from surgical procedures, and occasionally migraine headaches. The drug can also be found in rectal . The latter form of morphine is usually given to people suffering from nausea. A liquid form of morphine is available for oral use among patients who have difficulty swallowing pills.
Some patients use morphine pumps. These come in two forms. Either the patient is hooked up to a needle (IV) and can press a button to increase the flow of morphine through the needle, or a morphine dispenser is implanted under the skin, releasing a set dose of the medicine at hourly intervals. The pumps are usually programmed so that a patient cannot receive too much morphine and overdose. Too much morphine can lead to death by stopping a patient's breathing.
Morphine is usually sold illegally on the street in its pill forms. Users crush the pills and snort, smoke, or inject them.
Are There Any Medical Reasons for Taking This Substance?
Morphine is used most often to ease the pain of dying from cancer. Cancer causes tumors (abnormal growths) in just about any organ in the body, from the brain to the limbs. These tumors can cause intense pain that never goes away. Morphine does not shrink tumors. Rather, it causes the brain not to respond to the pain that the tumor causes. Patients know they are in pain, but they feel more comfortable. Their anxieties are also eased by the relaxing components of the morphine.
Newspapers and magazines report cases of end-stage cancer patients who, with high doses of morphine, are able to take care of themselves around the home, do tasks such as gardening and attending family functions, and even work on projects they want to finish before death. workers who try to make dying patients as comfortable as possible report a greater sense of calm and less trauma for the patient and family when morphine is used to sedate and control pain.
Recovery from surgery without morphine would be a terrible ordeal for many patients. Even though the drug is often used only for the first few days, it greatly eases the pain and trauma the patient feels after a procedure. Used in this way it does not promote addiction. As the body recovers, doctors reduce the doses of the painkiller, eventually switching to over-the-counter products such as aspirin, acetaminophen, or ibuprofen.
Morphine's Not for All Patients, Though
For chronic, or ongoing, conditions such as back pain and migraine headache, morphine is never used as the first drug for treatment. Typically the drug is only prescribed for people who have used other opiate or opioid painkillers, or other prescription drugs, with disappointing results. Morphine's side effectsa href="#" class="def">toleranceA condition in which higher and higher doses of a drug are needed to produce the original effect or high experienced., constipation, nausea, drowsiness, and dizzinessake it a drug of last resort for people in pain.
Some people suffer pain that does not respond to morphine. This kind of pain, known as nerve damage, is particularly frustrating both for patients and their doctors. If nerves are damaged, they cannot read the chemical message morphine sends them.
Doctors who prescribe morphine must be certified to do so by the U.S. Drug Enforcement Administration (DEA). Morphine prescriptions require extra paperwork to determine how much medicine each patient receives and whether or not the doctor is
over-prescribing it. In response, doctors tend to under-prescribe morphine for two reasons. First, doctors do not want to be seen as dispensing drugs without good reason. Second, doctors do not want to take the chance that a dose they deem safe for a patient might actually lead to a fatal overdose.
Morphine enters the illegal market in two ways. Most of it is transformed into heroin in illegal laboratories in Asia, Mexico, and South America and smuggled into the United States. The rest is diverted from its legal use through theft from pharmacies or through "doctor shopping" for prescriptions. An illegal practice, doctor shopping occurs when an individual continually switches physicians so that he or she can get enough of a prescription drug to feed an addiction. This makes it difficult for physicians to track whether the patient has already been prescribed the same drug by another physician. Additionally, some morphine fatalities can be tied to people legally taking the drug, but taking it in higher doses than recommended, or combining it with other painkillers, alcohol, or cocaine.
People of all ages and income levels abuse prescription painkillers, sometimes with fatal results. Users often start taking the prescription drug for a painful condition and wind up abusing it for the mental effects. It is difficult to determine the number of deaths caused by morphine every year because heroin shows up as morphine on drug tests. Sometimes the cause of death is simply listed as "opiate overdose," and this could also include codeine or other prescription painkillers.
According to the "2003 National Survey on Drug Use and Health (NSDUH)," an estimated 119,000 teenagers between twelve and eighteen had tried heroin at least once. If given a drug test, these teenagers would test positive for morphine. Emergency room mentions of pure morphine are much lower than those for heroin, OxyContin, and Vicodin. The strength of morphine, the difficulties doctors face prescribing it, and the close watch kept on supplies in hospitals and pharmacies tend to keep illegal supplies low. Plus, the higher purity of illegal heroin makes that drug more attractive for abuse.
Effects on the Body
Morphine floods a group of receptors in the brain and spinal column that take in and enkephalinsPronounced en-KEFF-uh-linz; naturally occurring brain chemicals that produce drowsiness and dull pain.. Biologists think that endorphins and enkephalins work together naturally to dull pain or to ease anxiety when someone is hurt or close to death. Morphine replaces these natural molecules, and in a much greater quantity than the body can supply. Pain signals surging from an injury or a cancerous tumor cannot relay their messages to the brain because morphine has blocked the receptors that register the pain, while rewarding the receptors that enhance pleasure. Patients may still hurt, but the pain will not bother them as much, and they will be able to concentrate on other aspects of life.
Not Typically Abused for a High
Morphine is not as fat soluble as heroin, so even when injected it does not produce the instant rush of pleasure that makes heroin attractive as an abused drug. Nevertheless, morphine does induce a dreamy state of happiness, drowsiness, and relief from anxiety that can last from four to six hours, depending on the dose and the way it was administered. Most people taking morphine for pain learn to live with the drowsiness and confusion. Some opt to live with the pain instead so that their senses are not dulled by the drug. Usually patients will work closely with their doctors to monitor doses so that a balance can be achieved.
Scientists are finding that patients in pain can become tolerant to very high doses of morphineoses that, if taken recreationally, would kill a person outright. Tolerance, or needing higher doses of a drug to achieve the same results, is a standard side effect of opiate use.
All opiates produce similar side effects in the body. Morphine users will typically develop constipation because the drug slows muscle movement in the bowels. Breathing may be slowed as well. The drug can affect coordinationsers must adjust to the medicine before driving or operating machinery. Other side effects include nausea and vomiting, loss of appetite, loss of sexual function, and pinpoint pupils. Some people develop a mild allergic reaction in the skin that causes itching or prickling.
Even when used as directed, morphine can cause symptoms if a dose is missed or the medication is stopped suddenly. These symptoms include sneezing, runny nose, muscle aches, insomnia and anxiety, diarrhea, muscle twitching, sweaty and clammy skin, and goose bumps.
Reactions with Other Drugs or Substances
Because morphine can slow breathing and reaction time, it is much more dangerous when taken with alcohol, tranquilizers, , anti-anxiety medications, antidepressants, or even over-the-counter allergy medicines. Doctors must also monitor patients who take the pill form of morphine for reactions with other medicines metabolized in the liver, including medicines for tuberculosis, such as Rifampin, and medicines for seizures and epilepsy, including Dilantin. Some antibiotics can increase the level of morphine retained in the bloodstream.
Cancer patients on chemotherapyA medically supervised regimen of drugs used to kill cancer cells in the body. The drugs have potential side effects including nausea, vomiting, and other reactions. may have difficulty taking morphine because the drug can upset the stomach. These patients sometimes experience relief by using rectal suppositories or by using
pumps that bypass the stomach. However, doctors must evaluate the loss of appetite that results when morphine and chemotherapy are combined.
Some drug abusers combine morphine and cocaine. This can be particularly deadly, especially in terms of addiction. The two drugs work differently in the brain, causing high levels of disorientation, and both are habit-forming. Addicts who use opiates and cocaine at the same time find it hard to free themselves completely of both drugs.
Treatment for Habitual Users
Morphine use can lead to addiction. Even after years of not using the drug, opiate users can still crave the drug because they remember how they felt when they were taking it. Withdrawal from morphine and other opiates is a difficult task that lasts three to five days, if the user quits "cold turkey." More commonly, addicts seek treatment with methadone or buprenorphine, medications that will curb the withdrawal symptoms and block the effects of morphine in the brain. (An entry on methadone is available in this encyclopedia.) A morphine overdose that has caused breathing to stop can be treated with naloxone (Narcan), a drug that quickly rids the body of opiates. However, many opiate deaths occur in private settings. The user stops breathing, and no one is present to call for emergency care.
Health professionals advise anyone wishing to end morphine dependency to work closely with doctors and a psychiatrist or other therapist. If the dependency was brought about by morphine's use as a painkiller, a doctor may taper the dose so that the patient gradually becomes free of the drug. If the dependency comes from recreational use, the addict must learn strategies to live free of the drug's influence, often including finding new friends and staying away from the people and places associated with the drug use. Doctors and nurses who take opiates recreationally often lose their jobsobs they had trained for over many years.
Narcotics Anonymous (NA) is a self-help group that allows recovering addicts to meet and obtain assistance from other people who have lived through drug abuse. The nonprofit organization has a telephone helpline and group meetings in most cities and towns in the United States. Opiate dependency is one of the toughest addictions to beat, and the support of a group of peers is extremely helpful during moments of , anxiety, or depression.
One of the most serious consequences of a heroin or morphine addiction is the long-term profile a person creates for his or her future health care. Doctors are reluctant to prescribe powerful painkillers to people who have no history of drug abuse. They are much less likely to prescribe these drugs to people who have abused opiates in the past.
Advocates for the terminally ill point to another consequence of recreational opiate use. Some people in pain view prescription painkillers as dangerous and addictive, products that will make them crazy, or make them sleep all the time, or turn them into criminals. Such people suffer needlessly because of the negative perception attached to opiates. Doctors feel this too. They feel they are being monitored by the government and their jobs may be in jeopardy if they prescribe too much pain medication. As a consequence, they under-prescribe, even for dying patients. The bottom line: Many people suffer pain because other people abuse painkillers.
The Controlled Substances Act of 1970 placed morphine on the Schedule II list of controlled substances. This means that the U.S. government deems morphine to be a drug with medicinal uses that also carries the potential for abuse and addiction. Doctors who wish to prescribe morphine must register with the U.S. Drug Enforcement Administration (DEA). Morphine prescriptions are not like the typical slips of paper issued for most prescription drugs. They are more complicated and must be filed with the DEA, where records are kept on each doctor and how much morphine he or she prescribes. If the DEA determines that a doctor is prescribing too much morphine, that doctor can face criminal prosecution and possible jail time.
Illegal possession or sale of morphine, or any Schedule II drug, carries serious penalties, even on a first offense. Anyone caught with the drug can expect fines of as much as $10,000, mandatory drug testing, loss of driver's license, loss of federal government college financial aid, and a permanent criminal record. Judges often order opiate abusers into clinics. Second offenses almost always carry jail time and very heavy fines.
Because morphine is so habit-forming, its use can lead to other sorts of crime. People craving the drug are more likely to rob homes in search of cash or valuables. They are more likely to break into pharmacies or to commit armed robbery. They may resort to prostitution to pay for their habits, making themselves vulnerable to the human immunodeficiency virus (HIV) and other sexually transmitted diseases. An arrest for any of these offenses will result in jail time, where the addict will receive little treatment as he or she faces drug withdrawal.
For More Information
Arsenault, Kathy. In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines. Somerville, MA: Firefly Press, 2002.
Gahlinger, Paul M. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse. Las Vegas, NV: Sagebrush Press, 2001.
Hodgson, Barbara. Opium: A Portrait of the Heavenly Doom. San Francisco, CA: Chronicle Books, 1999.
"Beware of Morphine Overdoses." Drug Topics (October 20, 2003): p. 8.
Girsh, Faye. "Death with Dignity: Choices and Challenges." USA Today Magazine (March, 2000): p. 62.
Harvey, Kay. "As Her Condition Deteriorates, Gwen Frazier Faces the Loss of Her Independence." St. Paul Pioneer Press (April 28, 2000).
Hopkinson, Tom. "Morphine Produced in the Human Brain." Chemistry and Industry (October 4, 2004): p. 8.
Hurley, Mary Lou. "New Drug for Postop Pain Is Now Available." RN (October, 2004): p. 76.
McAlpin, John P. "Pakistani Paramilitary Troops Seize Morphine, Weapons Near Afghan Border." America's Intelligence Wire (August 13, 2004).
"Nine Days in June: Drugs Claim Two Sports Starsnd 147 Others." Life (January, 1987): p. 83.
O'Neill, Terry. "Morphine, Murder and Mercy: New Painkilling Guidelines Clarify Issues Surrounding Treatment of the Terminally Ill." The Report (October 21, 2002): p. 42.
Ostrom, Carol M. "Oregon Doctors Concerned with Improving Quality at the End of Life." Seattle Times (May 14, 2000).
Rauch, Sharon. "Living, Dying with Pain." Knight Ridder/Tribune News Service (February 20, 2002).
"Schiavo Denied Communion as Parents' Legal Battle Reaches Desperate Point." Detroit Free Press (March 27, 2005).
Shnayerson, Michael. "The Widow on the Hill." Vanity Fair (May, 2003): p. 122.
"2003 National Survey on Drug Use and Health (NSDUH)." Substance Abuse and Mental Health Services Administration (SAMHSA). http://www.drugabusestatistics.samhsa.gov (accessed July 30, 2005).
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See also: Cocaine; Codeine; Fentanyl; Heroin; Hydromorphone; Methadone; Opium; Oxycodone
Morphine (Contemporary Musicians)
How low can you go? That's the musical question posed by Morphine, purveyors of "low rock," a bottom-heavy, cacophonous rumble you can feel in your bones. It's produced by a decidedly unusual grouping of instruments: a baritone sax, drums, and a unique two-string bass that's played like a slide guitar. Unlike most rock bands, Morphine doesn't use a guitar or piano to carry the melody or fill sonic space. Instead, those notes are implied, like in certain jazz tunes, but the overall impact of Morphine's music can't be denied. Like the band's name implies, low rock's effect is disorienting, feels somewhat illicit, and it totally addictive.
The concept of the low-rock sound was created by Mark Sandman, who died of a heart attack while performing in Italy on July 3, 1999. In some ways, he was the ultimate scenester among the Boston/Cambridge music community, maintaining numerous side projects before and during his tenure in Morphine. Creatively restless, he began experimenting with low sounds when he played in the Boston blues-rock quartet Treat Her Right. There, Sandman played a conventional six-string guitar, but did so through an octave-shifting effects pedal that made the instrument sound more like a bass.
He then switched to a conventional bass, but one with just a single string, reasoning (somewhat Zen-like) that all the notes he'd need to play were on that one string. By the time Morphine took off, he'd added a second string. Later, he would add a third, albeit one from a guitar, and call the invention the Tritar. Obviously, experimentation and innovation came naturally to Sandman, who was just 46 when he died.
Songwriting came naturally, too, and to hear a tune by Morphine is to hear something that's quite removed from mainstream pop and rock. Besides "low rock," Morphine's sound is sometimes called "beat noir," in reference to its jazzy feeln a perfect world, the sound you'd hear emanating from a smoky bar at unreasonable hours of the morningut also its lyrical content, which is often dark, hard-boiled, and full of intrigue.
Sandman played with his Treat Her Right bandmates David Champagne, a guitarist and the leader of that group, harmonica player Jim Fitting, and drummer Billy Conway who would later join Morphine on the albums Treat Her Right, released in 1986, Tied to the Tracks, released in 1988, and What's Good For You released in 1991. The first was released independently, but the second was recorded for RCA, who didn't know how to market the band's quirky sound and sensibility. For the third, they were back to indie status, working with Boston-based Rounder Records.
As Treat Her Right was in its final throes, Sandman was gigging all over the place, most frequently at Cambridge nightspots the Plough & Stars and the Middle East. His various bands included Supergroup, a collaboration with Seattle-based Chris Ballew, who would eventually rise to fame with the Presidents of the United States of America. There was also Treat Her Orange (later the Pale Brothers), which found Sandman playing with mandolinist Jimmy Ryan of the Blood Oranges, and the Hyposonics, whose membership included future Morphine saxman Dana Colley and Either/Orchestra leader Russ Gershon.
Morphine, too, started out as just one among many of his projects, but Sandman was quick to recognize its potential. He formed the trio with Colley and drummer Jerome Deupree. As Boston Phoenix columnist Matt Ashare wrote of Morphine, "[It] best captured the essence of Sandman's singular style: his deadpan delivery, his wry pulp-noir vignettes, his 'less is best' aesthetic, and his love of loose R&B grooves rooted equally in the deep meaty blues of Howlin' Wolf and Muddy Waters and the savvy pop funk of an artist like Prince, who was one of his all-time favorites."
The band's debut album was released through Russ Gershon's Accurate/Distortion label in 1992. The next year, it was picked up by the independent but nationally distributed Rykodisc label, based in Salem, Massachusetts. There was nothing special about the songs themselvesWe write pretty standard three-minute rock songs with verses, choruses, and hooks," Sandman told the Boston Phoenixbut the vibe of those songs was as indelible an individual stamp as a rock band can hope to muster these days.
Just as their music stood outside the mainstream, so did Morphine's approach to the business of music. They didn't open shows for larger acts very often; instead, they did their own modest headlining tours, setting up short residencies in various towns and allowing their audience to develop organically. Sandman knew how to exploit what he had to work with, and let the press run with the band's odditiese invented the term "low rock" for that very purposeut kept the particulars of his private life out of the papers.
While they were recording their second album, Cure for Pain, Deupree was replaced with Treat Her Right skinsman Billy Conway. The album, released in 1993, was less than a commercial sensation, but gained much wider exposure when some of the songs were used prominently in the film Spanking the Monkey. That, and almost universal critical praise, raised the group to a level of popularity that it was able to maintain until its untimely end.
"Listening to early Morphine creates a sensation similar to slowly burning yourself with a cigarette," wrote Addicted to Noise contributor Seth Mnookin around the time of the release Morphine's third album, Yes in 1995. "It's a little scary, very intense, and impossible to stop because you're so determined to feel what's going to happen next." That sort of response was typical of a Morphine fan, and the group sated its public's desire for material with numerous singles sprinkled with bonus tracks and songs on various soundtracks. A collection of such odds and ends, B-Sides and Otherwise, surfaced in 1997.
Just before that, Morphine became the second act signed to DreamWorks records, the music arm of the entertainment conglomerate owned by Steven Spielberg, David Geffen, and Jeffrey Katzenberg. The album Like Swimming found the band varying the low-rock sound to a degree, incorporating instruments such as guitar, tritar, mellotron, and female background vocals into the mix. Ultimately, though, low rock was Morphine's hook, not an end in itself, and there were no hard and fast rules about what could and couldn't be done within the context of the band.
That became even more the case on The Night, the album Morphine had finished just before Sandman collapsed on a stage outside Rome and was pronounced dead-on-arrival at a local hospital. The Night seems a fitting epitaph, however, because its music finds Morphine's sound taken to its logical conclusion as a unique brand of chamber-rockdding more, and somehow ending up with less. Only Morphine could do that. Keyboards, violin, cello, and double bass, acoustic and electric guitars, oud, and various hand drums are played on the album. Drummer Deupree is back, too, playing in tandem with Conway on nearly every track. In some ways, the album is the lowest of the low, which is meant as both a compliment and a tribute to Sandman, who brought something unique to musicomething not very many musicians can claim.
The Night may have been Sandman's final work, but it was not the last word on his legacy. In late 1999, Morphine's surviving membersonway, Colley, and Deupree as wellormed Orchestra Morphine, a big band that toured the country, playing Sandman's music in a new, and wholly fleshed out fashion. Sidemembers included Either/Orchestra leader and Accurate Records executive Russ Gershon, trumpeter Tom Halter, keyboardist Evan Harriman, bassist Mike Rivard, and singers Laurie Sargent and Christian McNeill.
Whether Orchestra Morphine can go on to create new music without Sandman seems unlikely, though not entirely impossible. "He was a visionary," DreamWorks chief Lenny Waronker said of the fallen musician. "He invented a sound that was unique. He was one of a kind; he was uncompromising. It might be a cliché to call someone the real thing, because too many say that these days, but in his case its the truth. He was truly the real deal."
Good, Accurate/Distortion, 1992; Rykodisc, 1993.
Cure for Pain, Rykodisc, 1993.
Yes, Rykodisc, 1995.
Like Swimming, Rykodisc, 1997.
B-Sides and Otherwise, Rykodisc, 1997.
The Night, DreamWorks, 2000.
"You Look Like Rain," The Best of Mountain Stage, Vol 7, Blue Plate, 1994.
"Yes," National Lampoon's Senior Trip Original Soundtrack, Capricorn, 1995.
"I Had My Chance," "Bo's Veranda," Get Shorty, Antilles, 1995.
"Radar," Safe and Sound, Mercury, 1996.
"Gone for Good," 2 Days in the Valley Original Soundtrack, 1996.
"Kerouac," Kerouac: Kicks Joy Darkness, Rykodisc, 1997.
"This Is Not a Dream (with Apollo 440)," Spawn: The Album, Epic, 1997.
"11 O'Clock," Phoenix Original Soundtrack, Will Records, 1998.
"Honey White," MTV 120 Minutes Live, Atlantic, 1998.
"Hanging on a Curtain," La Femme Nikita Original TV Soundtrack, TVT, 1998.
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Morphine (Encyclopedia of Drugs, Alcohol, and Addictive Behavior)
Morphine is a major component of OPIUM, a product of the poppy plant (PAPAVER SOMNIFERUM or P. album). Named after Morpheus, the Greek god of sleep, morphine is a potent ANALGESIC (painkiller) that is widely used for moderate to severe PAIN. Morphine is one of approximately twenty ALKALOIDS in opium; it was first purified in 1806 and, by the mid-1800s, pure morphine was becoming widely used in medicine. At approximately the same time, the hypodermic needle and syringe was developed, which permitted the injection of the drug under the skin (subcutaneous, S.C.), into muscles (intramuscular, I.M.), or directly into the veins (intravenous, I.V.). Together, these routes of administration are termed parenteral. Injections provide rapid relief of pain and can be used in patients who are unable to take medications by mouth. These advantages led to the wide use of morphine injections during the American Civil War (1861-1865). At that time, the intense euphoria and addictive potential of these agents following injections was not fully appreciated, leading to the addiction of a large number of soldiers. Indeed, morphine was not illegal and was sold over the counter; ADDICTION soon became known as the Soldier's Disease.
Since that time, a major objective of pharmaceutical companies has been to develop, for medication purposes, a nonaddictive analgesic with the potency of morphine. The concepts of PHYSICAL DEPENDENCE and addiction were not clearly differentiated until the late twentieth century, and it is likely that most of those early addicts were attempting to prevent the onset of WITHDRAWAL symptoms. Today very few patients become addicted to opiates, despite the fact that with continued administration all will become physically dependenthis may reflect our better understanding of the drugs plus our ability to take a patient off medications without precipitating withdrawal symptoms.
Morphine produces a wide variety of actions, some desired and others not. The definition of a desired action and a side effect depends on the reason for using the drug. For example, opiates such as morphine can be used to treat diarrheaut their constipating actions are usually considered an undesirable side effect when they are used to treat pain.
Clearly, the control of pain remains the most important use for morphine. Morphine and other OPIATES relieve pain without interfering with traditional sensations. Patients treated with morphine often report that the pain is still there but that it no longer hurts. Morphine works through mu opiate RECEPTORS located both within the brain and the spinal cord. Morphine has a number of other actions as well. Its ability to constrict the pupil is one of the most widely recognized signs of opiate use. In addition, morphine produces sedation and, at higher doses, morphine will depress respiration.
Morphine also has a major influence upon the gastrointestinal tract, which is the basis for its antidiarrheal effect. Here, morphine decreases the motility of the stomach and intestine, through local actions on the organs themselves, as well as through control systems located within the brain and spinal cord. Other systems can be affected as well. Morphine produces a vasodilation, in which the peripheral blood vessels are relaxed. This can lead to significant drops in blood pressure when a person shifts from a lying to a standing position as the blood is pooled in the legs. This ability to pool blood in relaxed blood vessels can be used clinically to treat conditions such as acute pulmonary edema, an accumulation of fluid within the lungs, which occurs in acute myocardial infarctions (heart attacks). Increasing the capacity of the vascular system by relaxing the blood vessels permits the reabsorption of the lung fluid. Finally, morphine and similar drugs, such as CODEINE, are also effective agents in the control of coughing.
All these effects of morphine can be easily reversed by ANTAGONISTS. NALOXONE is the most widely used antagonist. Given alone, it has virtually no actions; however, low doses of naloxone are able to block or reverse all the actions of morphine described above.
Morphine is given either by mouth or by injection. Oral administration is associated with a significant metabolism of the drug by the liver, explaining its lower potency as compared to that attained by injections. From three to six times more morphine must be taken by mouth to produce the same effects as an injected dose. Thus, higher doses are needed when giving the drug orally. Morphine injections can be given either intramuscularly, subcutaneously, or intravenously. Continuous infusions are also becoming more common, but their use is restricted to physicians expert in the treatment of pain. Morphine has a relatively short half-life in the body, around two hours, and it is usually given to patients every four to six hours. It is extensively metabolized. In the late 1980s, it was discovered that one of these metabolites, morphine-6β-glucuronide, is very potent, far more potent than morphine itself. The importance of this compound with a single morphine dose is probably not great; however, with chronic dosing, the levels of morphine-6β-glucuronide in the blood actually exceed those of morphineo this metabolite may be responsible for most of morphine's actions. Since this metabolite is removed from the body by the kidneys, special care must be taken when giving morphine to patients with kidney problems.
One common problem associated with morphine is nausea. This is difficult to understand, since nausea does not occur in all patients and often is seen with one drug but not others. This lack of consistency raises questions about whether it is a specific receptor-mediated action or whether it may be a nonspecific side effect.
With chronic use, morphine has a progressively smaller effect, a phenomenon termed TOLERANCE. To maintain a constant action it is necessary to increase the dose. Along with tolerance, morphine also produces physical dependence. Physical dependence (physiological dependence; neuroadaptation) develops as the body attempts to compensate for many of morphine's actions. As long as a person continues to receive the drug, no symptoms are noted. Abrupt cessation of the drug or the administration of an antagonist, such as naloxone, produces a constellation of symptoms and signs termed the withdrawal syndrome. Early symptoms include a restlessness, tearing from the eyes and a runny nose, yawning, and sweating. As the syndrome progresses, one sees dilated pupils, sneezing, elevations in heart rate and blood pressure, and goosefleshhich is responsible for the term "cold turkey." Cramping and abdominal pains are also common.
Physical dependence (or neuroadaptation) is a physiological response to repeated dosing with morphine and is seen in virtually all patients. Physical dependence, however, is not the same as addiction (drug dependence). Drug dependence (addiction) is defined as drug-seeking behavior, whereas physical dependence is simply a physiological response to the medication. While addiction is common among drug abusers, it is rare when morphine is used for appropriate medical conditions. The reasons for this difference are not clear, and they remain a major issue in understanding and treating morphine addiction.
(SEE ALSO: Addiction: Concepts and Definitions; Diagnostic and Statistical Manual; Opiates/Opioids; Opioid Complications and Withdrawal)
REISINE, T., & PASTERNAK, G. (1996) Opioid analgesics and antagonists. In J. G. Hardman et al. (Eds.), The pharmacological basis of therapeutics, 9th ed. (pp. 521-555). New York: McGraw-Hill.
GAVRIL W. PASTERNAK