Based on a rapid review of systematic reviews of observational studies looking at the benefit of IV/intra-osseous morphine for the management of acute pulmonary oedema, the National Essential Medicines List Committee (NEMLC) has recommended the removal of morphine from the EML for this indication. 

This decision was based on the conclusion that morphine may increase both in-hospital and all-cause mortality as well as substantially increase the need for invasive mechanical ventilation. Click here to see the circular, which also contains links to the full evidence review.