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Vol 13, No 1 (2019)
Review paper
Published online: 2019-04-04
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Undiscovered morphine. The effects of the long-term use of the opioids

Zbigniew Żylicz12
DOI: 10.5603/PMPI.2019.0004
·
Palliat Med Pract 2019;13(1):22-26.
Affiliations
  1. International Association for Study on Pain, United States
  2. European Association for Palliative Care, Italy

open access

Vol 13, No 1 (2019)
Review paper
Published online: 2019-04-04

Abstract

Morphine and other opioids are used much more often and for a longer time than before. This causes many relatively unknown adverse effects, which become apparent only after a while. One of them is opioid-induced hyperalgesia and abnormal magnesium metabolism. The adverse effect that negatively influences the quality of life is opioid-induced hypogonadism. Morphine can have a profound immunosuppressive and tumour-promoting effect. It is probably responsible for the increased rate of heart infarctions. Very interesting are suggestions that morphine and other opioids are changing the large bowel microbiome. All of these phenomena do not concern only few patients but are generalized in this population and the severity of the phenomenon depends only on the treatment period. Jet none of these adverse effects are mentioned in drug leaflets. All of these phenomena are treatable providing that the diagnose is made accurately and timely. It is very well possible that in the future we shall be able to prevent most of these adverse effects. Palliat Med Pract 2019; 13, 1: 22–26

Abstract

Morphine and other opioids are used much more often and for a longer time than before. This causes many relatively unknown adverse effects, which become apparent only after a while. One of them is opioid-induced hyperalgesia and abnormal magnesium metabolism. The adverse effect that negatively influences the quality of life is opioid-induced hypogonadism. Morphine can have a profound immunosuppressive and tumour-promoting effect. It is probably responsible for the increased rate of heart infarctions. Very interesting are suggestions that morphine and other opioids are changing the large bowel microbiome. All of these phenomena do not concern only few patients but are generalized in this population and the severity of the phenomenon depends only on the treatment period. Jet none of these adverse effects are mentioned in drug leaflets. All of these phenomena are treatable providing that the diagnose is made accurately and timely. It is very well possible that in the future we shall be able to prevent most of these adverse effects. Palliat Med Pract 2019; 13, 1: 22–26

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Keywords

morphine, fentanyl, opioids, buprenorphine, opioid-induced hyperalgesia, hypogonadism, magnesium, osteoporosis, myocardial infarction, immunosuppression, induction of cancer growth, gut microbiome

About this article
Title

Undiscovered morphine. The effects of the long-term use of the opioids

Journal

Palliative Medicine in Practice

Issue

Vol 13, No 1 (2019)

Article type

Review paper

Pages

22-26

Published online

2019-04-04

Page views

817

Article views/downloads

1078

DOI

10.5603/PMPI.2019.0004

Bibliographic record

Palliat Med Pract 2019;13(1):22-26.

Keywords

morphine
fentanyl
opioids
buprenorphine
opioid-induced hyperalgesia
hypogonadism
magnesium
osteoporosis
myocardial infarction
immunosuppression
induction of cancer growth
gut microbiome

Authors

Zbigniew Żylicz

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