Does morphine make death come sooner?
Concerns are commonly raised about whether opioids speed up the dying process, and this question has been extensively studied.
There is no evidence that morphine or other opioids accelerate the dying process when used in dosages needed to control pain or dyspnea. In fact, there is evidence of the opposite effect. Palliative care providers notice that once pain is controlled, the dying process seems to slow down sometimes. This hasn’t been proven in prospective scientific studies, but pain is a stress on the body and it seems logical that relieving pain decreases the burden of illness on people who are frail.
People may think morphine contributes to the dying process because it’s often used when people are in advanced stages of illness. The patient is declining because of the illness, with or without the morphine. This is particularly noticeable when someone elderly has pain from cancer or another illness that’s strong enough to require pain medication such as morphine. In such instances the burden of illness is significant.
While morphine and other opioids may have significant side effects, these tend to show up when morphine is first started or after an increase in dosage. After several days of opioid therapy, tolerance develops to these adverse effects, and even doubling or tripling the dose is generally well tolerated.