title: Chronic arthritis pain management with topical morphine: case series.
abstract: Chronic pain is a major health problem in the United States affecting 50 to 75 million Americans. The extent of pain encountered with chronic disease states may impact an individual's quality of life. Morphine is the drug of choice for severe pain. The primary purpose of the study was to determine analgesic response with the use of topical morphine to control chronic pain in a series of patients with arthritis pain. The second purpose was to detect the presence of morphine in the urine following topical administration and subsequently conclude that there had been systemic absorption of the drug. Three patients were prescribed topical morphine for chronic pain and were followed over the course of several weeks. Each patient was instructed to record the date and time of the topical morphine applications. When each patient had achieved a satisfactory level of pain control a 24-hour urine collection was obtained and taken to a laboratory for analysis. All patients reported a satisfactory degree of pain relief following topical application of morphine. The urine analysis confirmed the presence of morphine in the 24-hour samples. This analysis confirms systemic absorption of the morphine across intact skin; however the results cannot be used to quantify the degree of systemic absorption. Results of the study indicate that the use of topical morphine is effective in controlling chronic pain and topical morphine is absorbed systemically in the body.
authors.affiliation: Creighton University School of Nursing, Omaha, NE 68178, USA.
authors.forename: Marlene
authors.initials: M
authors.lastname: Wilken
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Ineck
authors.forename: Ann M
authors.initials: AM
authors.lastname: Rule
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use* / Q000652:urine; D001168:Arthritis / Q000150:complications*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use* / Q000652:urine; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement
chemical_list: D000701:Analgesics, Opioid; D005782:Gels; D009020:Morphine