When abuse becomes frequent or compulsive these issues can become severe and long-lasting. Repeated or chronic morphine insufflation can cause crusty skin in the nose, bloody noses and persistent sores. In addition to this, a person may suffer from chronic bad breath halitosis , runny nose or sinus infections sinusitis. Some people may have complete or partial loss of their sense of smell.
Some people may use morphine to cope with the sense of shame or embarrassment they experience from these conditions. These actions place them at a greater risk for overdose and other serious complications of morphine abuse. Some people end up getting plastic surgery to repair the physical damage caused by snorting morphine. The damage to the nose can affect other aspects of physical health too.
The nose is responsible for filtering and cleaning the air a person breathes before it reaches the lungs. Tiny hairs inside of the nose called cilia have a major role in this task. People who snort morphine on a regular basis can damage these hairs. Call now to be connected with one of our compassionate treatment specialists. Morphine abuse begins for many reasons, the most common of which are self-medication and the pursuit of high or euphoric feelings.
When abused, morphine is referred to as Dreamer, Morf, Morpho, and Unkie. In addition to injectable preparations and oral solutions, morphine is prescribed as immediate- and extended-release tablets and capsules.
Any form of morphine may be abused in these ways, however, when snorted, people use the tablet or capsule versions. MS Contin is a prescription extended-release tablet that is commonly abused. Also raw opium, crude morphine, and morphine hydrochloride, although the only narcotic mentioned as contained in the pills was heroin. The usual pills were coloured uniformly throughout, but the "Fairy Horse" pills were white inside, coated bright pink. They weighed 0.
The defendants arrested in the pill cases were all Chinese with the exception of one Japanese. The same report mentions the seizure of two heroin factories, one of which was revealed by an explosion and resultant fire; and it is evident that at this time the heroin was locally manufactured, as well as the pills themselves.
It was also stated, "Since there has been observed a steady increase in pill addiction which in recent years has become prevalent to such a degree that it exceeds the smoking of opium itself.
This widespread addiction is attributable to the fact that pills are comparatively much cheaper than opium. It is estimated according to statements made by addicts that 16 pills, which can be procured for 20 cents, have the same effect as approximately 50 cents worth of opium.
Chiefly for this reason pill smoking has spread among a large section of the poorer people, many of whom were formerly addicted to the smoking of opium and are now turning to this form of vice which is more within their means. Pill smoking in Hong Kong increased from to , and continued to hold its own in spite of repressive measures up to The 'Fierce Tiger' brand was not found so frequently as in but various local brands were popular They were usually of a lighter pink colour than the 'Fierce Tiger' pills and contained on the average one milligram of heroin per pill with the usual caffeine, cincho-nine, sugar or sugar of milk, gum, and possibly strychnine.
It was noticed that the pills were slightly perfumed with rose water or vanillin solution. The poprular local brands were 'King of Flowers' peony , 'Spring Waters,' 'King of Fragrance' and other adaptations of popular names.
Heroin Pill divans were discovered on many occasions. In these divans no opium was smoked and it was noteworthy that conditions in those divans were cleaner than those in opium divans; in fact, a better class of smoker appeared to frequent these divans.
In other cases, divans were raided in which both Heroin Pills and Opium were available. It appears that two or three Heroin Pills are equal to one pipe of good prepared opium and the advantages claimed by smokers of these pills for the use of the pills instead of opium are:. The Annual Report for Hong Kong stated, "The traffic in diacetylmorphine pills has increased enormously.
During the year, , of these pills were seized in cases There was no direct evidence of the import and export of these pills. All indications go to show that they are manufactured in Hong Kong in small hand-type factories.
These factories do not appear to remain in one building for many weeks; the pills after manufacture are immediately passed on to wholesale distributors. It was also mentioned in some reports that heroin was seldom found when a pill factory was seized; the narcotic was evidently brought in at the last moment and the batch mixed immediately.
The Annual Report of Hong Kong for stated, "The situation as regard Diacetylmorphine Heroin Pills became rapidly worse in the early part of the year. It became obvious that these pills were being manufactured on a large scale in Hong Kong and special investigations were carried out with the object of attacking the actual makers.
Persons found in charge of factories or engaged in the manufacture of these pills were committed for trial at the Supreme Court In many cases persons were found actually making the pills with the usual hand pill machines The only known local use of Caffeine of any considerable extent is the manufacture of the pills under discussion.
If the amount of caffeine available for local consumption is taken as 8, pounds or approximately 3, kilos a very low figure this gives Caffeine content for at least million pills of the type usually found.
In view of the large seizures of these pills this figure probably gives an accurate idea of the local consumption. The narcotics cases at the Hong Kong Supreme Court in resulted in 46 persons convicted with sentences totalling years. A table of seven pages was given tabulating the details in regard to seizures of pill "factories.
During the year 3,, of these pills were seized in cases, the great majority of the pills being found in pill factories. Many persons were found carrying these pills and special mention must be made of the number of young persons who were not of the lowest classes found smoking these pills in pill divans. Enforcement was very rigorous and was believed to be getting the upper hand. However, the recorded caffeine imports were up to 12, pounds.
Again in the traffic in Heroin pills "did not increase. Suppression measures were continued rigorously. In the number of cases involving pills rose to , from in , and 3,, pills were seized.
Caffeine imports were 14, pounds, and it was believed that at least 12, pounds of caffeine were intended for pill manufacture. Harm Reduction Journal volume 17 , Article number: 48 Cite this article.
Metrics details. It is not always easy to advise people who inject drugs PWID on how to prepare their drugs in a way that is associated with reduced harm. This is particularly true for pharmaceutical drugs that are not meant to be injected.
The following outcomes were compared: particle reduction and morphine content in the filtrate, as well as filtration ease and time. Moreover, the suspension obtained was easy to filter using membrane filters.
Particle reduction was important with all three membrane filters tested. The provision of a method that is easy to use, reduces harms associated to the injection of insoluble particles and recovers virtually all the active drug has a large chance to be adopted by people who use drugs. This study was set up to examine the influence of different preparation practices, including filtration, on particle count, morphine concentration and filtration ease. Ideally, this type of practices will result in the elimination of harmful insoluble particles associated with an easily filterable solution, and a high morphine content, encouraging people who inject drugs to use this method.
Besides illicit drugs such as heroin and cocaine, some PWID inject pharmaceutical drugs. The injection of such drugs is becoming more and more common in many countries, like France, the USA, Canada and Australia [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ].
There may be different reasons for using or even preferring pharmaceutical drugs. They may be easier to obtain in some contexts, their nature and dosage are known, and their use may be more acceptable in some groups. The injection of pharmaceuticals entails complications which, for some, are inherent to insoluble tablet fillers such as talc, starch and microcrystalline cellulose.
Their injection can give rise to several complications such as abscesses, ulcers, granulomas and phlebitis, pulmonary embolism, fibrosis and talcosis [ 8 , 9 , 10 , 11 ]. Filtration can prevent or delay these complications by removing insoluble particles from the suspension prior to injection. Membrane filters, such as the Sterifilt and wheel filters, are more efficient in eliminating particles from a solution than cotton or cigarette filters that are commonly used by PWID [ 12 , 13 , 14 ].
In France, one of the pharmaceuticals commonly diverted by injection is Skenan, a slow release capsule formula of morphine sulphate. The major preparation method for this drug involves heating after adding the active substance to the solution [ 17 , 18 ].
Because of the presence of starch, when heated, the suspension becomes highly viscous. Therefore, the more efficient membrane filters tend to clog up and are not often used. New drug preparation guidelines have also been taken up by PWID in other contexts [ 19 ]. But, despite the promotion, by harm reduction professionals of a cold preparation technique for Skenan, this advice has not been followed up [ 17 ]. It is thus plausible that there is a good reason to heat this drug.
Some mention a lack of tingling feelings when they use the cold technique and a membrane filter; others mention an enhanced high when heating [ 20 ]. This might be true. The solubility of morphine is Most PWID in France inject mg or mg capsules; they may heat in order to dissolve the available morphine in a small volume 1-mL and 2-mL syringes are used. McLean et al. Low solubility may not be a limiting factor under these conditions.
According to other sources [ 23 , 24 ], a higher temperature does seem to enhance morphine or morphine sulphate solubility. Thereafter, the suspension is stirred and filtered through either a small piece of cigarette filter or a cotton filter. Though very rare personal observation in the field , some people use the cold preparation method. Membrane filters can be easily used with this preparation method. This technique seems promising as it is used by a large number of users, and it is compatible with membrane filtration.
First of all, the microbeads contained in the capsule are crushed and put aside. Water is poured into the cooker and heated until the first bubbles appear. Fairly quickly, the crushed powder is added to the lukewarm water and the solution is stirred. Subsequently, the solution is filtered either through a membrane filter only or through a membrane filter that is positioned on top of a cotton filter, called combined filtration.
Prepared in this fashion, the solution is still a little viscous, but it goes through membrane filters; the presence of a cotton filter underneath prevents the filter from clogging and enhances the filtration speed. Many professionals in the field of harm reduction including the author have been wondering for a long time what would be the best technique for the preparation of this drug.
This pushed the fund to write a protocol and to subsequently request Ethypharm to perform the lab work on its product. The lack of a clear regulation places health professionals and their patients in condition of random treatment success. Morphine as an option of opiate substitution, even for a limited number of patients, deserves to be explored and better supervised for the benefit of all.
For filtration, the following filters were used Fig. Filters used. In the field of harm reduction, they are called "wheel filters" Sartorius, Germany. This is the successor of the Sterifilt described by Scott [ 14 ] and Roux et al. It is characterized by a larger filtration area, increased filtration speed and decreased risk of clogging during filtration Apothicom, France.
Other materials used are a hot plate to heat the solutions, standard g white paper and a lighter to crush microbeads and a digital microscope Keyence VHX to visualize the insoluble particles in the filtrate. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Get emergency medical help if you have signs of an allergic reaction : hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Serious side effects may be more likely in older adults and those who are malnourished or debilitated. Long-term use of opioid medication may affect fertility ability to have children in men or women. It is not known whether opioid effects on fertility are permanent. This is not a complete list of side effects and others may occur.
Call your doctor for medical advice about side effects. Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:. This list is not complete. Other drugs may affect morphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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