Kids Health Info

Palliative care – morphine

  • Morphine is a very effective medicine for pain management that is used often in both adults and children. It is a strong pain reliever (analgesic), and it can also be used to manage shortness of breath.

    Morphine is commonly used in children to relieve their pain. Well-controlled pain may help your child to continue to move about and have a better quality of life. 

    If your child’s pain stops, they can gradually stop taking the morphine. The medication is not addictive when used appropriately to treat pain.

    How morphine is 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 that they only need to take one or two times a day.

    Children who cannot take medicine by mouth may be given morphine directly into a vein through a drip (intravenous or IV therapy) or under the skin (subcutaneous or sub-cut). They may then have a portable pump that they carry about with them. The pump releases controlled and regular doses of morphine.

    How much morphine is given?

    The dose needed is very individual. Some children need more than others. The correct dose is the amount that eases your child's pain. Your doctor will work out a starting dose, which may need to be increased or decreased.

    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. It is important that a specialist nurse or doctor supervises changes in the dose as any changes must be monitored carefully. 

    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. Morphine is not addictive when used appropriately.

    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, your 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 that your child can take instead.

    Stopping morphine

    If your child’s pain stops, they can gradually stop taking the morphine. 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.
    • Children are commonly given morphine to relieve pain, which can help them continue to move about and have a better quality of life.
    • Side effects of morphine include constipation, nausea, drowsiness, slowed breathing or itching. Some side effects get better with time, some can be managed with extra medication, and others will improve with a change in dose.
    • If your child’s pain stops they can gradually stop taking the morphine.
    • Morphine is not addictive when used appropriately.

    For more information

    Common questions our doctors are asked

    Will morphine make my child high?

    No, your child will not get ‘high’ on morphine. When they are first given the medication, they may feel drowsy, but this will improve after a few days. Your child’s doctors and nurses will manage the amount of morphine that your child is given to minimise any side effects like drowsiness, while still effectively relieving your child’s pain.  

    I’ve read morphine is highly addictive. Why do you say it isn’t?

    Morphine acts to manage existing pain, and when given in the correct dose and at the correct frequency, does not have addictive qualities. When used in the absence of pain, or if too much is given for the amount of pain your child is experiencing, then side effects and addiction can become problematic.

    Are there any alternatives to morphine if morphine does not suit my child?

    Yes. There are alternatives to morphine and medical staff will be able to provide advice about which one will suit your child best.


    Developed by The Royal Children's Hospital Palliative Care and Pharmacy departments and Children's Pain Management Service. We acknowledge the input of RCH consumers and carers.

    Reviewed October 2018.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.

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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. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.