Opioid (Narcotic) Pain Medications
Opioid (Narcotic) Pain Medications
When you have a mild headache or muscle ache, an over-the-counter pain reliever will usually suffice. However, if your pain is severe, your doctor may advise you to take something stronger, such as a prescription opioid.
Opioids are a class of narcotic pain relievers. If you don’t use them correctly, they can have serious side effects. People who are addicted to opioids frequently began with a prescription.
If you need to take opioids to control your pain, here are some precautions you can take to ensure you’re doing so safely.
How Opioids Work
Opioid drugs bind to opioid receptors in the brain, spinal cord, and other organs. They inform your brain that you are not in pain.
They’re used to treat moderate to severe pain that hasn’t responded well to other pain relievers.
Opioid drugs include:
- Codeine (only available in generic form)
- Fentanyl (Actiq, Abstral, Duragesic, Fentora)
- Hydrocodone (Hysingla, Zohydro ER)
- Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
- Hydromorphone (Dilaudid, Exalgo)
- Meperidine (Demerol)
- Methadone (Dolophine, Methadose)
- Morphine (Kadian, MS Contin, Morphabond)
- Oliceridine (Olynvik)
Your doctor can prescribe most of these drugs to take by mouth. Fentanyl is available in a patch. A patch allows the medication to be absorbed through the skin.
Working With Your Doctor
You’ll need a prescription from your doctor before you start taking opioids. The doctor can adjust the dose as needed to help control pain.
You may receive around-the-clock doses to manage pain throughout the day and night. And your doctor may prescribe opioids to be taken “as needs” in case you have “breakthrough” pain — a flare of pain that you get despite round-the-clock doses.
While you’re on opioid pain medications, check in with your doctor regularly. Your doctor will need to know:
- How your pain is responding to the drug
- Whether you’re having any side effects
- If you have any potential interactions or medical conditions that could make you more likely to have side effects, such as sleep apnea, alcohol use, or kidney problems
- Whether you’re taking the drug properly
Never change or discontinue any opioid medication without first consulting your doctor. If a pain reliever isn’t working as well as it should, your doctor may change the dose, add more, or try a different medication.
When you’re ready to stop using opioids, your doctor may help you wean yourself off of them gradually if you’ve been using them for a long time to give your body time to adjust. Otherwise, you may have withdrawal symptoms.
Opioid Side Effects
One of the reasons why your doctor needs to manage pain medications so closely is that they can cause side effects, such as:
- Nausea and vomiting
- The drugs lubiprostone (Amitiza), methylnaltrexone (Relistor), naldemedine (Symproic), and naloxegol (Movantik) are approved to treat constipation due to opioid use in those with chronic pain.
Opioids can be dangerous if you take them with alcohol, or with certain drugs such as:
- Some antidepressants and anxiety medications (particularly benzodiazepines such as alprazolam, ativan and clonazpam)
- Some antibiotics
- Sleeping pills
Make sure your doctor knows all of the other medicines you’re taking.
Opioid Tolerance and Addiction
After taking opioid pain medication for a while, you might find that you need more and more of the drug to achieve the same effect in easing pain. We call this tolerance. It’s not the same as addiction, which involves a compulsive use of a drug.
When you use opioid medication over an extended period of time, you can have dependence. This can happen when your body becomes so used to the drug that if you abruptly stop taking it, you get withdrawal symptoms such as:
- Diarrhea, nausea, and vomiting
- Muscle pain
You can also get a serious addiction to opioid pain medications. People who are addicted compulsively seek out the pain medications. Their behavior usually leads to negative consequences in their personal lives or workplace. They may take someone else’s pills or buy them off the street, which is especially dangerous since those drugs are often laced with lethal amounts of fentanyl. Learn more about what can happen when opioid addiction goes untreated.
Should You Take Opioid Pain Medications?
Opioids can make a dramatic difference to people with moderate to severe pain. These drugs can be an effective therapy — as long as you use them safely and follow your doctor’s instructions carefully.