Opioids and Persistent Pain

By Ricardo Austin,2014-08-27 08:22
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Opioids and Persistent Pain

Opioids and Persistent Pain

Narcotics for Pain Narcotic pain relievers are called opioids. Opioids are the most

    effective pain medications, but also the most seriously abused.

    A list of commonly used drugs with generic and trade names

    appears at the end.

    All opioids have about the same ability to relieve pain and the

    same general problems with side effects, tolerance, and the

    potential for misuse. To use them effectively for the relief of

    pain, you should understand a number of things about opioid


    Addiction Myths About Pain

    Medicines Fear of addiction is the main reason that many people fight using

    opioids for pain relief. Addiction is a compulsive use with

    increasing amounts of drugs that continues despite serious

    negative effects on health and lifestyle.

    Addiction almost never occurs when opioids are taken as

    directed for treating persistent pain.


    Tolerance is the gradual loss of both the beneficial effects and

    side effects of a medicine. Tolerance may develop with regular

    opioid use.

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    Myths About Pain Tolerance to side effects, such as the sleepiness produced with Medicines, initial doses of opioids, is good. Often after a few days of use,

    continued the sleepiness you feel goes away and allows you to use even

    larger doses of opioids for severe pain without excessive


    Tolerance to the beneficial effects, such as the ability to relieve

    pain, is a problem. Over time the pain relief from the amount of

    medicine you started with will gradually lessen, but should never


    Tolerance can always be overcome with more medicine. If you

    have persistent pain, you will need to find a balance between

    pain relief, costs, and negative effects of larger doses.

    Tolerance has nothing to do with addiction. If your pain

    medicine stops working, talk to your doctor. It could be due to a

    change in your underlying condition.


    Withdrawal is the development of certain predictable symptoms

    when the use of opioids is stopped too quickly. Withdrawal

    symptoms include nausea, sweating, and anxiety. Withdrawal

    has nothing to do with addiction.

    You can easily avoid withdrawal by gradually reducing the

    amount of opioids taken until they can be stopped without


Positive Changes You take opioids to make your pain better and to make your

    life better. For most people, this means resuming activities that

    were stopped by your pain and illness.

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    Positive Changes, Take advantage of the opportunity that pain relief brings to add

    continued something positive to your life. If you take opioids to eliminate

    your pain without improving your life, the pills may become the

    focus of your life and can do more harm than good.

    Talk to your family about how much the opioid is helping your

    mood, function, and attitude. If the opioid is not helping, talk to

    your doctor. You should not keep taking a drug that is making

    your life worse.

    Opioid Types Common opioids can produce long-acting and short-acting

    results. See the table at the end for a list of short- and long-

    acting opioids.


    Most opioids in their usual form are short acting. They take

    effect in a half hour or so and relieve pain for about four hours.

    Short-acting opioids, which are often combined with an over-the-

    counter pain reliever like acetaminophen (Tylenol), are good to

    use before you do something that usually causes pain.

    Occasional use of short-acting opioids minimizes side effects

    and is least likely to cause tolerance and withdrawal symptoms.


    Long-acting opioids are put into a special time-release tablet,

    capsule, or skin patch. The medicine is released gradually and

    gives a continuous level of pain control for the effective time

    specific to the medication.

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Long-Acting, continued Opioid Types,

    continued The oral, long-acting versions are usually taken every 8 to 24 hours, and the patch type is designed to last 3 days.

    Long-acting medicines are used when you need some pain control at all times, or at least for a longer period than the

    4 hours of the short-acting type.

    Long-acting opioids can be combined with short-acting

    medicines to boost the effectiveness of the pain medicine at specific times of the day, when better pain control can help you function better.

    Using long-acting opioids continuously will cause some


    Side Effects The side effects of opioids should be anticipated and actively managed.


    The most predictable side effect of opioid treatment is constipation. If you plan to take opioids regularly, start a bowel program when you start the opioids and before you feel


    If you become seriously constipated and have pain, you may need medical help. Drinking lots of liquids and taking a stool softener or stronger laxatives are usually the first step in starting

    a bowel program.

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Side Effects, Other side effects you may experience include:

    continued Nausea Slower brain function

     Fatigue Sedation or sleepiness

    These side effects usually go away in a few days without

    treatment. However, you need to be careful and think about how

    to avoid falls and accidents when the medicine is making you


    If side effects continue, talk to your doctor about other opioids or

    steps you can take to minimize the side effects you are having.

    Regular Doctor You will need to visit your doctor regularly while you take Visits opioids to evaluate how effective the treatment is, discuss side

    effects, and adjust your medicines.

    Don’t forget that the success of your pain management will be

    decided mostly by what you do with your life now that your pain

    is improved.

Opioid Drug

    morphine MSIR, Roxanol Short-Acting Types

     oxycodone OxyIR, Oxyfast,


     oxycodone Roxilox, Roxicet,

    Percocet, Tylox, (with acetaminophen)


     hydrocodone Vicodin, Lorcet, Lortab, Zydone, Hydrocet, (with acetaminophen)


     hydromorphone Dilaudid, Hydrostat

    morphine MSContin, Oramorph Long-Acting

    SR, Kadian, Avinza

     oxycodone Oxycontin

     fentanyl Duragesic patch

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