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Pain Management with Opioids

Opioids are a group of narcotic drugs that are used to treat coughing and diarrhea and are often prescribed to help control pain. In addition, opioids are used as anesthetics during surgery. Opioids are classified as depressants and can be addictive.

Types of Opioids

Opioids are often classified by how the drugs are sourced. Three types of opioids are available:

Natural opioids, often referred to as opiates, are derived from the seed pods of opium poppy plants.
Semi-synthetic opioids are made by adding chemicals to natural opiates.
Synthetic opioids are made completely synthetically and do not include any natural opiates.

Opioid Side Effects

Side effects of opioids can include:

constipation
drowsiness
dry mouth
extreme pain sensitivity
itching
nausea
pinpoint pupils of the eye.

Opioids, when taken improperly, can lead to drug addiction. Therefore, when taking opioids, always follow your doctor's orders. Do not increase dosages if the pain killers become less effective over time without discussing your situation with your physician first.

Also, never take any opioids that were not prescribed specifically to you.

Natural Opiates

Natural opiates include codeine and morphine.

Codeine is included in:

Fiorinal®
Robitussin A-C®
Tylenol® with codeine.

Codeine is generally combined with other analgesic painkillers such as Tylenol® and is used to treat mild to moderate pain.

Morphine is also known by the following names:

Duramorph®
Morphine Sulfate
MS Contin®
Roxanol®.

Morphine is used to treat moderate to severe pain and severe diarrhea.

Semi-Synthetic Opioids

One type of semi-synthetic opioid is heroin. Other semi-synthetic opioids include:

Hydromorphone, with a brand name of Diaudid®, is produced from morphine and is used to treat moderate to severe pain as well as severe coughing.
Meperidine, with the brand name Demerol®, is used to treat moderate to severe pain.
Percocet® is a brand name of a combination of oxycodone and aspirin and is used to treat moderate to severe pain.
Percodan® is a brand name of the combination of oxycodone and acetaminophen (brand names includes Tylenol®) and is used to treat moderate to severe pain.

Synthetic Opioids

Synthetic opioids include:

Darvon® is the brand name of a propxyphene and aspirin combination that is used to relieve mild pain.
Fetanyl, or brand name Sublimaze®, is used as an anesthetic during surgery and to treat moderate to severe pain.
Methadone, or brand name Dolophine®, is used to treat drug withdrawals.

Long-Term Pain Management with Opioids

Because opioids can be addictive, opioids are not generally prescribed for long-term pain management. However, opioids are sometimes prescribed for pain management during terminal illnesses, as addiction is less of a concern than comfort in those situations.

Opioids and Medical Conditions

Discuss any medical conditions that you have with your physician before he prescribes a medication from the opioid family. You might not be able to take opioids if you suffer from:

asthma
colitis
emphysema
enlarged prostate
heart disease
liver disease.

In addition, discuss any medications that you are currently taking with your doctor to prevent negative drug interactions.

If you are pregnant or are planning on getting pregnant, talk to your doctor about any implications that taking opioids might have for you. Also, avoid taking opioids when breast feeding, as some opioids can be transferred to your baby through breast milk.

Resources

Centre for Addiction and Mental Health (2007). Do You Know …
Opioids. Retrieved August 24, 2007, from the CAMH Web site:
http://www.camh.net/About_Addiction_Mental_Health/Drug_
and_Addiction_Information/opioids_dyk.html.

Psychology Today (2006). Opioids. Retrieved August 24, 2007,
from the Psychology Today Web site:
http://psychologytoday.com/conditions/opioids.html.

Schaffer Library of Drug Policy (n.d.). Frequently Asked
Questions about the Opioids. Retrieved August 28, 2007, from
the druglibrary.org Web site:
http://www.druglibrary.org/schaffer/heroin/opifaq.htm.

University of Texas MD Anderson Cancer Center (n.d.). Pain
Management Opioid Side Effects: What They Are and How to
Cope. Retrieved August 29, 2007, from the mdanderson.org
Web site:
http://www.mdanderson.org/topics/paincontrol/display.cfm?
id=C51CC50C-FDC8-4D7E-B40ED49B77130859&
method=displayFull.

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