Dangers of Morphine for the Dying

Dear Barbara, Talk about the dangers of giving morphine to one who is dying?

I have written many articles on morphine yet I repeatedly get this question. What that tells me is how big the fear is, and how lacking the knowledge, around the use of morphine.

Here are my thoughts on the use of morphine at the end of life. First and foremost dying in itself is not painful. Disease causes pain. If the disease history of the dying person is one of experiencing pain, than we must treat that pain with whatever it takes and however much it takes to keep the person comfortable until their very last breath.

There are diseases that do not cause pain. If the person's disease history is one of no pain then there is no reason to give them morphine just because they are dying. UNLESS breathing is an issue, not the normal puffing and start and stop breathing that occurs weeks and days before death, but severe labored breathing. Then a small, small, amount of morphine will often ease the difficulty in breathing. We must remember that taking in oxygen by breathing is one of the ways the body lives. If it is preparing to die then breathing and air intake will be effected. That is part of the NORMAL dying process.

I had a friend who drank an entire bottle of liquid morphine in a suicide attempt. He had no previous use of the drug, so its full effect acted on his body. He slept a long time but did not die. A different person (body size, age) might have died. But my friend didn’t . This tells me our bodies can take a lot of morphine and not stop breathing.

I will ask the obvious question here: If, when someone is in the dying process (days, hours or weeks before death), the morphine dosage were to make them die, is that really a consideration? Yes, I think it is. No caregiver wants to live with the knowledge that the medication they administered made their patient die (I think this is the center of caregivers fear of narcotic administration).

In the days to hours before death a person’s body is shutting down. Nothing works right. Circulation is slowing down (mottling, very low 60/40 blood pressure). It is circulation that makes medications work. Medications taken by mouth, skin, or rectum take a long time to be absorbed into the blood stream. Even longer if the circulation is compromised which it is when a person is dying. If you give a narcotic other than through an IV (let’s hope most people are not getting IV’s in the days to hours or a week before their death from disease) it is going to take a VERY long time for this medication to work.

If you give morphine to someone who is in the dying process hours before death and they die shortly after you administer the medication they most probably did not die from the drug. They would have died with or without the narcotic.

All of the above said, I am going to give you something to think about. The key to a gentle death is to relax. All we have to do to slip out of our body is to relax. Fear, pain, and unfinished business are what make our “labor” to leave this world longer. If someone is very agitated (fearful) and/or has a disease history of pain then giving them medications that can reduce those occurrences can be very beneficial to allowing the person to relax and have a gentle passing from this world to the next.

Something More About "Dangers of Morphine for the Dying?"...

Hospices and Palliative Care Centers are using my dvd, NEW RULES for End of Life Care to educate families on how and why morphine may be used with a loved one why is dying. It is so common for nurses to hear families say, "I don't want Mom to get addicted", and not allow use of this helpful tool. NEW RULES... can help to make this conversation so much easier.



Hi Corrina, your question “Is it dangerous to give morphine every hour?” is one I can’t answer. Pain management, particularly pain management at end of life is so individualized I would have to have more information about your cousin’s medical history. What I can say is our goal in working with end of life pain is to keep the person comfortable. If pain was an issue in the disease (and a lot of cancers, including the kind your cousin had, produce pain) then we address that pain with medication right up until the moment of death. I hope this information puts your mind at ease. You might want to talk with the hospice nurse and ask her your questions. Even though your cousin has died you can still call hospice and ask your questions. My blessings are with you. Barbara

Corrina Slade

My Cousin passed away yesterday at 12:30 a.m ..i was there with her and left at 9:30 p.m before she passed …i arrive there at her house at 6 that evening the whole time i was there she was administered morphine every hour on the hour by her daughter following the Hospice nurse directions…it really didn’t sit right with me but those were the directions from the hospice nurse….my question is….is it dangerous to give morphine every hour??? Oh by the way..she was fighting cancer..she was diagnosed 3 wks ago..lesions in the brain and found mass on her lung n liver…


Hi Marta, when a person is not experiencing pain I see no reason to give them a narcotic or any kind of medication as a pain reliever. If there is breathing difficulties a small amount of morphine may ease the breathing but that doesn’t seem to be the issue here. The family can certainly tell the hospice nurse they are not comfortable with the use of morphine, at this time. We need to remember any agency, physician or healthcare professional works for the family and patient. Their opinion matters. We just want to make sure the opinion comes from knowledge and not fear and/or ignorance. Blessings! Barbara


I am taking care of a patient in her last days/weeks of Alzheimer’s. She is not in pain, she is comfortable and her vital signs are steady, she has no issues with breathing. She still eats and drinks and eliminates pretty much regularly. Family decided to put her on hospice just few days ago. Hospice nurse instantly suggested giving her morphine. I do not see a need for it just yet. Does family have to agree to administering morphine immediately or can they wait till their mom actually would benefit from it to help her with peaceful passing?


Very informative information above.my husband has non treatable cholangiocarcinoma ,due to too many other health issues.He hasn’t shown any systems yet ,I plan an appointment with a hospice nurse to come to the house and speak with us and your prior information for me to read is very helpful.I have ordered 4 booklets from you and eagerly awaiting their arrival! My husband is almost 89 and though he doesn’t speak of the disease he has shown remarkable strength !!

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