How Much Morphine Should Be Prescribed?

In comparison to other medications, opioid pain medications are more carefully regulated, have the potential for more severe adverse reactions, and written prescriptions are needed for dispensing. So, trying to provide the right amount is a little tricky. With this background, a recent study (M Aboud-Karam et al. J Pediatr 2015; 167: 599-604) examines the use of morphine after pediatric surgery.

This prospective study included 243 subjects. Findings:

  • 56% of participants who received a scheduled (“regular basis”) prescription administered the medication as ordered.  The most common reason for deviation was a lack of pain or mild pain relieved by acetaminophen.  33 of the 104 patients who received a scheduled prescription did not even pick up the medication from the pharmacy.
  • 85% of participants in the “as needed” prescription group were administered morphine as ordered; however, 76% of this group took two or fewer doses. In this “as needed” group, a subset of 77 participants had precise data about the amount of morphine that they received.  Less than 10 % of the prescription doses available were administered.

The authors note that morphine is covered in Canada by both private and government-based insurance plans such that there are unlikely to be financial constraints limiting medication usage.  They note that the unused medication is a safety hazard due to potential for accidental ingestions.

My take: this study suggests that prescriptions with fewer doses of morphine may be warranted.

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One thought on “How Much Morphine Should Be Prescribed?

  1. Pingback: Codeine and Tramadol –Additional Warnings | gutsandgrowth

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