Reports > Death Disguised > CHAPTER SEVEN - Drugs >
The Side Effects of Morphine and Diamorphine
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One of the two most important unwanted side effects of morphine and diamorphine is respiratory depression; the other is addiction. Morphine, when administered, has the potential to slow the rate of breathing and, ultimately, to stop breathing altogether. This must be taken into consideration when deciding whether to prescribe morphine or diamorphine and, if so, how much to prescribe. If a patient is in acute pain, respiratory depression is less likely to occur, since the potential of morphine to stop breathing is combated by the pain itself. If a person has no pain or distress when the drug is administered (for example, if he or she is taking the drug for 'recreational' purposes), there is no opposition to the potential to depress respiration and breathing is liable to become slower. Euphoria will also occur very rapidly. If a patient already has a condition causing respiratory depression, such as chest disease, the further depressant effect of the drug on the patient's breathing may easily give rise to danger. Other side effects of morphine, usually evident when a patient is first started on the drug, are dizziness, constipation and nausea.
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Morphine injections are delivered ready-mixed as a transparent liquid in little glass pots called ampoules; they are available in a variety of strengths. They are administered by drawing up the contents of the ampoule into a syringe by means of a needle. Diamorphine comes in powder form, also in an ampoule, and has to be mixed with sterile water for administration as an injection. The water is drawn up from an ampoule into a syringe and then squirted into the powder ampoule. The diamorphine solution is then drawn back into the syringe ready for injection. Diamorphine is easy to dissolve, so only a little liquid (about 1 to 2ml for a 10mg ampoule of diamorphine) is required. With an intramuscular injection, the smaller the volume used, the less uncomfortable the injection. Diamorphine is supplied in 5mg, 10mg, 30mg, 100mg and 500mg ampoules.
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An intravenous injection is most commonly administered into the large vein in the crook of the elbow, the next most favoured site being a vein on the back of the hand. The most usual sites for an intramuscular injection are the buttock, the big muscle on the outside of the thigh or the deltoid muscle in the upper arm.
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Morphine and Diamorphine
