{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:16:17Z","timestamp":1790615777303,"version":"4.1.0"},"reference-count":43,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,9,29]]},"published-print":{"date-parts":[[2016,10]]},"abstract":"\n Objective<\/jats:title>\n To examine the environmental life cycle from poppy farming through to production of 100\u2005mg in 100\u2005mL of intravenous morphine (standard infusion bag).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \u2018Cradle-to-grave\u2019 process-based life cycle assessment (observational).<\/jats:p>\n <\/jats:sec>\n \n Settings<\/jats:title>\n Australian opium poppy farms, and facilities for pelletising, manufacturing morphine, and sterilising and packaging bags of morphine.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n The environmental effects (eg, CO\n 2<\/jats:sub>\n equivalent (\u2018CO\n 2<\/jats:sub>\n e\u2019) emissions and water use) of producing 100\u2005mg of morphine. All aspects of morphine production from poppy farming, pelletising, bulk morphine manufacture through to final formulation. Industry-sourced and inventory-sourced databases were used for most inputs.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Morphine sulfate (100\u2005mg in 100\u2005mL) had a climate change effect of 204\u2005g CO\n 2<\/jats:sub>\n e (95% CI 189 to 280\u2005g CO\n 2<\/jats:sub>\n e), approximating the CO\n 2<\/jats:sub>\n e emissions of driving an average car 1\u2005km. Water use was 7.8\u2005L (95% CI 6.7\u2013 to 9.0\u2005L), primarily stemming from farming (6.7\u2005L). All other environmental effects were minor and several orders of magnitude less than CO\n 2<\/jats:sub>\n e emissions and water use. Almost 90% of CO\n 2<\/jats:sub>\n e emissions occurred during the final stages of 100\u2005mg of morphine manufacture. Morphine's packaging contributed 95\u2005g CO\n 2<\/jats:sub>\n e, which accounted for 46% of the total CO\n 2<\/jats:sub>\n e (95% CI 82 to 155\u2005g CO\n 2<\/jats:sub>\n e). Mixing, filling and sterilisation of 100\u2005mg morphine bags added a further 86\u2005g CO\n 2<\/jats:sub>\n e, which accounted for 42% (95% CI 80 to 92\u2005g CO\n 2<\/jats:sub>\n e). Poppy farming (6\u2005g CO\n 2<\/jats:sub>\n e, 3%), pelletising and manufacturing (18\u2005g CO\n 2<\/jats:sub>\n e, 9%) made smaller contributions to CO\n 2<\/jats:sub>\n emissions.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The environmental effects of growing opium poppies and manufacturing bulk morphine were small. The final stages of morphine production, particularly sterilisation and packaging, contributed to almost 90% of morphine's carbon footprint. Focused measures to improve the energy efficiency and sources for drug\n sterilisation<\/jats:italic>\n and\n packaging<\/jats:italic>\n could be explored as these are relevant to\n all drugs<\/jats:italic>\n . Comparisons of the environmental effects of the production of other drugs and between oral and intravenous preparations are required.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013302","type":"journal-article","created":{"date-parts":[[2016,10,22]],"date-time":"2016-10-22T00:03:08Z","timestamp":1477094588000},"page":"e013302","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":73,"title":["The Environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug"],"prefix":"10.1136","volume":"6","author":[{"given":"Scott","family":"McAlister","sequence":"first","affiliation":[{"name":"Eco Quantum Life Cycle Consultants, Brunswick, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjun","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Chemical Engineering, Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Neff","sequence":"additional","affiliation":[{"name":"Sun Pharmaceuticals, Princes Highway, Port Fairy, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Hapgood","sequence":"additional","affiliation":[{"name":"Department of Chemical Engineering, Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Story","sequence":"additional","affiliation":[{"name":"University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Mealey","sequence":"additional","affiliation":[{"name":"Baxter Australia, Toongabbie, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Forbes","family":"McGain","sequence":"additional","affiliation":[{"name":"Western Health, Footscray, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,10,21]]},"reference":[{"key":"2025121512284150000_6.10.e013302.1","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2008.008147"},{"key":"2025121512284150000_6.10.e013302.2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31824fcea6"},{"key":"2025121512284150000_6.10.e013302.3","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1065\/lca2006.04.019","article-title":"The role of SETAC in the development of LCA","volume":"11","author":"Kl\u00f6pffer","year":"2006","journal-title":"Int J Life Cycle Assess"},{"key":"2025121512284150000_6.10.e013302.4","unstructured":"Sustainable Development Unit. 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