Among remedies provided to ease human suffering, few have proven as widely effective as opium, according to 17th-century physician Thomas Sydenham. Morphine, its main derivative, remains the primary treatment for severe pain and has earned the description of a highly reliable medicine. It was administered to soldiers during wartime conflicts, where extreme discomfort sometimes led to distress, a challenge that persists today due to limited understanding and professional misconceptions.
Morphine was isolated from opium in 1805 by Friedrich Serturner but entered broad clinical practice only in the mid-1800s after the invention of the syringe. Seeking to reduce addiction risks associated with opium, Serturner created a refined compound offering stronger pain relief. Named after the Greek god of dreams, it derives from the opium poppy, Papaver somniferum.
The drug has since treated chronic pain from illnesses such as cancer and acute pain from events like heart attacks or operations. Its injectable form, however, also caused addiction, prompting global regulations in the early 20th century.
India passed the Narcotic Drugs and Psychotropic Substances Act in 1985, which severely restricted morphine access. This led to a 92 percent drop in consumption over 13 years, leaving the country with one of the lowest usage rates worldwide and causing unnecessary suffering for many patients.
One case involved a 36-year-old Chennai municipal worker with advanced stomach cancer who endured intense pain until receiving morphine tablets. He later questioned why the medication had not been provided earlier.
The World Health Organization urged governments to ease restrictions on tablet morphine. In 2001, India relaxed rules, allowing states to simplify approvals through a single agency and extending license renewals to three years for trained facilities. Kerala and Tamil Nadu led these changes.
Further amendments in 2014 and 2015 created a national category of essential narcotic drugs, enabling state controllers to authorize stocking by registered institutions. Progress has continued with the formation of the Indian Association of Palliative Care in 1994 and workshops on opioid access.
Tablet morphine is now effective, affordable, and accessible in most states. It follows the 1986 WHO guidelines for severe pain and can be used beyond end-of-life care to support ongoing treatment.
