Morphine Treatment for MS

Therapy for multiple sclerosis (MS) generally involves suppressing the immune system to slow the damage to the nerves, but patients often need ways to manage pain. Doctors thought for a long time that opiates such as morphine were not the best choice for pain treatment, but new studies suggest they should not be ruled out.

Definitions

• MS is a disease in which the body's immune system attacks the nerves of the brain and spinal cord, resulting in such symptoms as muscle weakness, tingling, numbness, blurred vision and pain. MS causes the immune system to break down the substance that covers the ends of nerves, called myelin, which becomes very painful for an MS sufferer.

  Morphine is a powerful painkiller that comes from the poppy plant. Such drugs are also called opiates, opioids or narcotics, and have been used to manage the pain of MS when anti-inflammatory painkillers are not successful.

HIstory and Studies

• Doctors believed that opiates such as morphine were not effective for long-term treatment of chronic nerve pain because they did not address what scientists call neuropathic, or nerve-related, pain. However, recent research is taking a new look at whether opiates may indeed be useful for managing MS pain.

  A recent study funded by the National Institutes of Health compared two treatment courses given over a two-month period to patients with varying neuropathic pain. The opiate levorphanol given in high doses reduced pain up to 36 percent. Other studies have evaluated more traditional methods of treatment such as antidepressant and anti-convulsant medications. They have had similar results.

Further Research

• Though researchers now agree that opiates such as morphine could be useful for managing serious MS pain, more research still needs to be done to understand how and why the drugs work. Also, morphine can be highly addicting and further research is needed to understand morphine as a good option for MS pain.

Administering morphine and side effects

• Morphine can be administered in several ways--intravenously (through a needle in the arm), liquid, tablet, suppository, or continuous pump. Patients sometimes may need to try different methods to determine the appropriate method for them.

  Side effects of morphine include drowsiness, fatigue, constipation, and difficulty breathing. Some of the side effects can be managed and the patient's physician should be aware of any breathing or lung problems prior to a morphine regimen. Any medication regimen should always be performed under the strict supervision of a doctor.