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Sister Morphine - A little bit of pain relief goes a long way—if you can get it

by Staff, Utne Reader
November-December 2011


Ultimately, excruciating but finite pain like that of childbirth is mostly tolerable (which explains why every mother doesn’t stop after her first child), but even mild chronic pain weighs on the spirit—and, neuroscientists have found, on the mind. Constant loud ringing in the ear, recurrent bladder infections, an ever-present ache in the mid-back all have the potential to change the function and even shape of the brain.

According to Science News (June 18, 2011), researchers at Montreal’s McGill University looked at a series of brain scans and found that people who suffered through a year of chronic back pain actually experienced a thinning of the left dorsolateral prefrontal cortex. As a result, activity in this brain region—which is linked directly to pain response—was both altered and abnormal.  

In addition, the researchers found that morphine can be used not only to treat pain, but also to help rehabilitate the brain. A six-month treatment of the painkiller relieved the nonstop backache—and spurred thickening in the dorsolateral prefrontal region.  

This news will gratify the journalism students and professors at the University of British Columbia who created the 2011 documentary Freedom from Pain, which, according to The Tyee (July 20, 2011), exposed the appalling lack of access to morphine in half the world. Led by Peter Klein, director of UBC’s journalism school and former 60 Minutes producer, the film exposes a global human rights crisis born out of “cultural bias, overzealous drug warriors, and lack of education.” It’s not cost that keeps morphine away from cancer patients in parts of India or Ukraine; it’s bureaucratic red tape and ignorance.  

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That's probably what kept me from losing my sanity during the worst of my treatment.

my favorite form of morphine, (i've never had any, only given it)

is Roxinal.  this is a super concentrated, sublingual form of morphine,

comes in bottle with an eye-dropper.

One drop, under the tongue, kicks in instantly.

Is great, super-fast method of delivery, needlefree way to adminster it, regardless of the person's ability to swallow or hold down pills.  You can walk into a room with a person hanging from the ceiling,

and in mere seconds, the person is calm and smiling.  Awesome stuff.  Smells like bandaids.  I made sure i had a bottle for my own mother when she was on her deathbed.



In the article above,

I wonder how many of these various attitudes against pain medicine have roots in religion... we can do so much better at controlling pain, ppl do not have to feel the amts of pain that they do.


 and nausea, too, pot pills are so great for nausea, haven't yet had a patient who said, "sorry, that pot pill did not help, i'm STILL nauseous" 

 I'm sure somewhere, is a person whose nausea can NOT be reduced by a pot pill, but, i haven't met them yet.

Drugs for nausea with far more side effects are dispensed by the hour, i mean really creepy side effects,


to this day,

many docs are hesitant to dispense pot pills, and I DO NOT UNDERSTAND THIS.

-------------- there are few if any side effects to a pot pill.  While other drugs for nausea can cause palsy, psychotic episodes, diarrhea, "fake strokes" (horribley frightening if you ever see one) horrible metallic tastes in your mouth, alterations in your blood counts, just all manner of horrific side effects, more than i can list here,

side effects which can last from hours to weeks after being given the "real" anti=nausea drugs


a pot pill

just leaves the patient kind of giggly, relaxed, and hungry.  HOw bad is that??? 



i dont' get the hesitancy from some doctors

to order pot pills

for those ppl who really need it, either.


One word: dilaudid.
Pills, patches and IM shots.

yeah, dilaudid is a top shelf choice, too!  mmmHmm. does not seem as fast/instantaneous as Roxinal, not even in it's IV form, but great med.


either way, there are ppl who say they don't like morphine, and ppl who say they don't like dilaudid.  Guess we humans are all our own unique blends of neurons and neurochemistries!

I've been told that chronic pain treated with morphine doesn't work in the long run. The theory is that morphine wears off over time. Dilaudid sounds interesting.


Chris, you are right, any human being, given any drug, be it morphine, dilaudid, demerol, whatever,  if givne the drug daily, for chronic pain,

will indeed develop a tolerance, and huger and huger doses will be needed over time, and eventually, if used daily, any drug may begin to have very small amts of relief, if used daily.


Even ppl who don't get pain meds daily, but who have had extensive exposure to pain meds, for fairly prolonged periods of time throughout their lives,

 tend to require much higher doses of a med to get the same amt of relief,

that a "virgin-liver" person of same age group (never had pain meds) would need.

this seems to be somewhat true of anti-anxiety meds as well, the more often a person takes them, the bigger doses are often needed over time to get same effect.


It can be stunning how much meds some ppl need to get anywhere near comfortable when they've had many many pain meds or anxiety meds, often, for prolonged periods of time, off and on but frequently throughout their lives.


fear of someone developing tolerance is valid concern for some patients. 


Sometimes ppl who have had multpile, extensive, prolonged exposure

 to pain meds throughout their lives,

when an major health event occurs to these ppl,  that needs big hammers to keep them comfortable, we are outa ammo that will actually work for these ppl by then, after years and decades of frequent pain meds being taken often.... 

and it's extremely difficult to manage these types of people's pain well.  Hard to explain, but, a medico would easily recognize what i'm describing.


as much as humanely possible, you want to try to avoid using the biggest available hammer you can find

 if if if if you can get by with a smaller one,


someday, you may need that bigger hammer in a really bad way.  hard to explain...i can't think of a good analogy to help you see what i'm saying.  but, a person who uses pain meds extensively,

can be actually raising the bar of medication needed to keep them anywhere near comfortable, over time.


dilaudid and roxinal are top of the line, i think.  If those wear off/if a person becomes tolerant of those, or now requires dosages that are not even legal, or safe, 

there's not a lot left to offer that person.  that's the scarey part..

alcohol is sort of the same way.  If someone drinks heavily, they tend to need larger amts of booze to get drunk,

compared to someone who never ever drinks, can get drunk on two drinks, three drinks for sure, while the heavy drinker still seems pretty close to mostly sober on 3 drinks.


it's kind of like that.


i think,

if you take a heavy drinker,

take away all their booze for a long time,

and then

give them a drink,

they will get a buzz on lesser amts of alcohol now

that they haven't had any booze for a long time.

(at least at first, until they re-escalate)



but, with drugs, re: their effectiveness for pain relief,

it's not quite that same way,

if someone has had tons o pain meds most of their lives,

and then no pain meds for long time,

they still tend to need higher doses than someone who has never had pain meds would. (in same age group)

so i guess that is not great analogy, either.

Thanks for taking the time to write that.

I've been taking morphine for five years. My dosage is less not than it was two years ago. The morphine helps, but not enough anymore. I've tried a bunch of neurological pharmaceuticals - none of them helped. I'm beginning to wonder if my headaches are, at least in part caused from sleep depravation. I'll go four days without sleep. As soon as I drift into sleep I get dizzy which increases my heart rate blood pressure and breathing which wakes me up. The other day I went to a different doctor and found out that there is a headache clinic. For the past 9 months or so I gave up on getting any help from the doctors, but I'm going to start pushing them again. At the end of January I'm going to a Neurotology panel where I'll spend the day with four different doctors to evaluate me. 

One of the reasons Afghanistan grows so much poppy pods is because of the drought. Apparently poppy grows better than wheat, or even crocus to make Saffron,

Neither Alcohol or Morphine works for my dizziness. I'm only getting about two hours of sleep per day- in 15 minute segments. When I close my eyes I have an anxiety attack. As soon as I fall asleep I wake up because my vestibular system is broken.

It's difficult to describe.


Sleep depravation is horrible.





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