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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking Morphine For Sleep Apnea. Breathing Problem Due To Asthma And Allergy. Swollen Neck And Throat. How Can I Come Off Medication?

I have sleep apnea and am being treated with morphine by a pain management Dr. I know this is not a good combination and have problems breathing even with the Bi Pap due to sinus issues, asthma , and allergies. All these issues are taking a toll on me to the point I m afraid, I ve even noticed my neck and throat are swollen each day which is another problem I do not know what to do? I m telling my Doctors but honestly don t think they know either. I d like to get off the pain meds but after 6yrs know the withdraws would be too intense. What would you advise if you were my Doctor? P.S. I am 51 and under 115lbs so weight is not an issue.
posted on Mon, 25 Mar 2013
Twitter Mon, 25 Mar 2013 Answered on
Twitter Tue, 26 Mar 2013 Last reviewed on
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General & Family Physician,  's  Response
Hello, although Morphine is a very potent opioid analgesic it is contraindicated in bronchial asthma, sleep apnoea & other lung problems. The reason is Morphine suppresses respiration. Morphine depresses all phases of respiratory activity ( respiratory rate, tidal exchange minute volume). It produces irregular breathing.
Morphine releases histamine, the substance that results in allergy. Hence should not be given in allergic conditions as it will increase it. Histamine also results in dilatation of peripheral blood vessels causing edema (swelling).
The swelling of neck & throat you are experiencing is due to histamine induced angioedema.
Since you are taking Morphine for 6 years, you cannot stop the drug suddenly as that will result in severe withdrawal symptoms. So the possible approaches by which pain can be managed are
1. if withdrawal symptoms are severe, then the opioid Methadone can be given instead of morphine. it is equally effective in relieving pain & will not result in withdrawal symptoms. but it also can result in respiratory depression.
2. if withdrawal symptoms are less severe, then analgesics like Diclofenac/Ketorolac which are similar to Morphine in relieving severe pain can be given. The dose of Morphine can be reduced gradually & these drugs can be substituted.
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Taking Morphine For Sleep Apnea. Breathing Problem Due To Asthma And Allergy. Swollen Neck And Throat. How Can I Come Off Medication?

Hello, although Morphine is a very potent opioid analgesic it is contraindicated in bronchial asthma, sleep apnoea & other lung problems. The reason is Morphine suppresses respiration. Morphine depresses all phases of respiratory activity ( respiratory rate, tidal exchange minute volume). It produces irregular breathing. Morphine releases histamine, the substance that results in allergy. Hence should not be given in allergic conditions as it will increase it. Histamine also results in dilatation of peripheral blood vessels causing edema (swelling). The swelling of neck & throat you are experiencing is due to histamine induced angioedema. Since you are taking Morphine for 6 years, you cannot stop the drug suddenly as that will result in severe withdrawal symptoms. So the possible approaches by which pain can be managed are 1. if withdrawal symptoms are severe, then the opioid Methadone can be given instead of morphine. it is equally effective in relieving pain & will not result in withdrawal symptoms. but it also can result in respiratory depression. 2. if withdrawal symptoms are less severe, then analgesics like Diclofenac/Ketorolac which are similar to Morphine in relieving severe pain can be given. The dose of Morphine can be reduced gradually & these drugs can be substituted.