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

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