Morphine remains the gold standard of medical practice. Morphine and other narcotics can be taken in a variety of ways. All methods control pain very effectively.
• Intravenous , or direct IV, morphine can be used when you are in the hospital or even at home. This route
delivers the drug directly into the bloodstream. A single IV dose rapidly relieves pain, but has a short duration
of action. Continuous infusion can be given this way.
• Morphine, pethidine, hydromorphone, methadone and oxycodone (Percodan and Percocet) are available in pills
or oral solution. Morphine and methadone are available as long-acting pills (8 to 12 hours) and morphine,
pethidine, hydromorphone and oxycodone are available in short-acting pills or solution.
• Most narcotics are available in rectal suppository form.
• Narcotics can be given by injection into muscles or under the skin.
• Most narcotics, but most often morphine and hydromorphone, can be given through a portable infusion pump
with a small butterfly needle inserted under the skin or as a slow intravenous infusion.
• Fentanyl, a very potent narcotic, can be given through a patch worn on the skin. These patches come in
various strengths and can provide pain relief for up to three days.
• Most narcotics can be given intraspinally. All narcotics relieve pain by binding to narcotic receptors in the
spinal cord and brain much like a lock and key, so narcotics given by this route are very effective at very low
doses. Whereas the pain equivalence between oral and intramuscular morphine is 3 to 1, the equivalence
between intraspinal and oral morphine is 300 to 1. This very large ratio usually means a much smaller dose is
