Morphine Equivalents - What Does It All Mean?


The nation’s opioid epidemic has quickly become a public safety issue, making the news almost every day. Several thought leaders within public and private agencies are aiming their efforts toward curbing opioid abuse and its associated outcomes. One such effort centers around the ability to understand how potent one opioid is compared to another in order to identify high risk opioid doses that can lead to overdose.

For a comparison of opioids doses, a tool was developed to equate the many different opioids into one standard value. This standard value is based on morphine and its potency, referred to as morphine milligram equivalents (MME) or morphine equivalent doses (MED).

Instead of figuring out and remembering what a risky dose is for each and every opioid, all opioids can now be converted to an equivalent of one medication – morphine – which allows ease of comparison and risk evaluations.

The process of converting an opioid dose to a morphine equivalent dose can be done using a morphine equivalent dose calculator, or morphine equivalent table, also known as an opioid conversion chart.*

Related: How Other States Are Fighting the Opioid Epidemic

Multiple studies have documented the risk of unintentional drug overdose associated with high doses of opioids, making the consideration of MED extremely important in today’s treatment plans. The Centers for Disease Control and Prevention (CDC) states, “Higher dosages of opioids are associated with higher risk of overdose and death – even relatively low dosages (20-50 morphine milligram equivalents (MME) per day) increase risk.”

The CDC also recommends using caution when prescribing opioids at any dosage and prescribing the lowest effective dose. MED can be used as a data point with patients to help describe potential dose-related risks for adverse drug reactions.

As THE Patient Advocate Pharmacy, IWP takes the national opioid epidemic seriously and works with prescribers to educate and discuss treatment options that are beneficial to patients and their recovery outcomes.

*It should be noted that morphine equivalent calculators should be used to identify/evaluate risk and not to convert from one opioid to another as they don’t account for interacting medications or specific characteristics of an individual.


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