Kids Health Info

Palliative care - morphine use

  • Morphine is a very effective medicine for pain management and is used often in both adults and children. Children are given morphine to relieve pain.  They will not get 'high' and will not get addicted. If their pain stops they can gradually stop taking the morphine.  Morphine used to relieve pain can help children continue to move about and carry on with their lives.

    What is morphine?

    Morphine is a medication which works very well for managing pain and shortness of breath. It is a strong pain reliever (analgesic). It is very commonly used in medical treatment and is used regularly at The Royal Children's Hospital.

    How is it given?

    Children can take morphine as tablets or liquid. They usually take it every few hours. Sometimes, if their pain is stable, they can take a special 'continuous release' or 'slow release' form of morphine which they only need to take one or two times a day.

    Children who cannot take medicine by mouth can have morphine through a small plastic tube that sits in a vein (intravenous or 'IV') or under the skin (subcutaneous or 'sub-cut'). They may then have a portable pump which they carry about with them. The pump releases controlled and regular doses of morphine.

    What is the dose?

    Your doctor will work out a starting dose which may need to be increased or decreased. The amount of morphine needed varies between children. It is important that a specialist nurse or doctor supervises changes in the dose as any changes must be monitored carefully. 

    The dose needed is very individual. Some children need more than others. The correct dose is the amount which eases your child's pain. So that your doctor can help achieve the best possible pain control, with the least side effects, you will need to tell them if you think your child continues to have pain or shortness of breath.

    Your child's body will get used to a certain dose of morphine and the dose may need to be increased over time. This is called 'tolerance'. A dose increase does not necessarily mean your child's condition is getting worse and does not mean that they are becoming addicted.

    Shouldn't we save it until my child really needs it?

    Many people think morphine means terminal care. In fact, it is recommended and used regularly for patients with severe short-term (acute) and long-term (chronic) pain.

    Morphine can be used for a long time and although the body does develop tolerance, the dose can be changed to achieve good control of a person's pain symptoms.

    Children can move about and participate in activities if their pain is well controlled. This improves their quality of life.

    What are the side effects of morphine?

    The side effects of morphine are well known and include:

    • Constipation - children taking morphine will often need to take a laxative and, if possible, eat a diet high in fibre to help prevent constipation.
    • Nausea and vomiting - nausea (feeling sick) or vomiting happens in some children but usually gets better in a few days. Some children need to take extra medication to help with nausea.
    • Drowsiness - many children are drowsy in the first few days after morphine is first started or after the dose is increased, but this also improves with time.
    • Slowed breathing - if the first dose is too high or the dose is increased too quickly, a child's breathing might slow down more than is wanted. This is why your child's doctor needs to supervise changes in dose.
    • Itching - some children get itchy skin when they are taking morphine. Your child's doctor will decide whether to treat this with another medicine if it happens.

    Very occasionally, side effects become a problem that cannot be managed well. If this happens there are other medications similar to morphine which your child can take instead.

    Will my child become addicted?

    Children are prescribed morphine to relieve pain. If their pain stops, they can gradually stop taking the morphine. They will not get 'high' and will not become addicted.

    Because the body becomes used to the morphine dose, it is important that the medication is not stopped suddenly. The dose must be reduced slowly over time under the supervision of a doctor.

    Key points to remember

    • Morphine is very effective for pain management and is used for both adults and children. It is used often at the RCH.
    • Children are given morphine to relieve pain. They will not get 'high' and will not get addicted. If their pain stops they can gradually stop taking the morphine.
    • Morphine can help children continue to move about and carry on with their lives.

    For more information

    Speak to your child's doctor, specialist nurse, pharmacist or the Children's Pain Management service at the RCH.

     

     

    Produced in consultation with the Royal Children's Hospital (RCH) Department of Palliative CarePharmacy Department and the Children's Pain Management Service. Many thanks to the parents who helped with this factsheet. First published March 2006. Updated October 2010.

Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts.