Rare presentation of intrathecal morphine withdrawal psychosis.

We report a case of a 57-year-old male patient with intrathecal morphine pump failure who presented with psychosis as part of a clinical presentation of opioid withdrawal. The patient was being treated for chronic back pain with an intrathecal morphine pump for several years. The patient spontaneously started to experience psychotic symptoms which included disorganized thinking, delusional thoughts, paranoia, auditory and visual hallucinations. Upon interrogation of intrathecal pump, it was found not to be functioning, thereby not delivering intrathecal morphine. After opioid rotation with administration of oral oxycodone, the patient's psychosis improved dramatically within a few days, clinically confirming psychosis due to morphine withdrawal. Therefore, it is important for physicians to consider opioid withdrawal in patients experiencing isolated psychosis.