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.


Janna Karsjens

I placed my husband on hospice/palliative care three days before his death. He had been in the nursing home for 2 months prior, supposedly for rehabilitative therapy after suffering a 2nd stroke. Unfortunately, he would get agitated every time he ran a fever. As his cognitive abilities decreased, the agitation increased. The palliative care nurse(s) recommended use of morphine to keep him relaxed and I’m very glad they did, because not only did it relax him, but it also helped me relax knowing that he was in no pain and was not suffering.

My biggest concern, should I ever be placed in hospice/palliative care, is that the nurses and doctors pay attention to noted medication allergies. I am allergic to morphine; I break out in a nasty itchy rash and become agitated, not calm. I would hope they would choose another medication to help me relax.

Patti Urban

As an end of life doula, I also agree that a small dose of morphine can have a good effect on someone who is experiencing labored breathing. It really does make a difference.


My husband had COPD and he took morphine on a regular basis for a year before he passed. His last dose of morphine was just moments before he passed. His last request was that we not let him suffocate. He went peacefully.

Maureen Asper

As a palliative care nurse, I can’t agree more with the use of morphine with terminal patients. Used properly morphine allows the patient to relax and will also address pain and shortness of breath effectively. A little bit can make a huge difference between a peaceful death compared to the last moments of life filled with anxiety and fear. It is also the drug of choice when shortness of breath becomes burdensome. It is a God-send for those suffering from COPD. Please don’t be afraid to try a small dose if your doctor suggests it.

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