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Thoughts on an obsolete and unhelpful word

HuggyHHuggy Posts: 321
edited 06/11/2012 - 8:47 AM in Pain Medications
I often see people using the word "narcotics" on this message board, and it makes me cringe every time. It's an obsolete, inaccurate and unhelpful term for pain-relieving medicines. The correct word for an analgesic derived from the opium poppy is "opioid". Narcotic can refer to cocaine, heroin, PCP, cannabis, barbiturates and all kinds of things; it has negative connotations that we in pain management just don't need. Surely we have enough problems already, dealing with chronic pain every day. Why add to our problems by using such a negative (not to mention imprecise) word that conjures up images of illicit substances and abuse and criminal behaviour? I have never heard opioids refered to as "narcotics" by any doctor in the UK, Europe, or in Asia, for what it's worth.

If you take a look at recent literature on pain medicine, the vast majority of it shuns this word. For example, the excellent 'Pain Assessment and Pharmacologic Management' by Pasero and McCaffery states: 'Avoid the word "narcotic". It has a negative connotation.' They define the word in the glossary thus: 'Narcotic: obsolete term for "opioid", in part because government and media use the term loosely to refer to a variety of substances of potential abuse.' I agree with them. Just my two cents, for what they're worth...


  • Excellent suggestion. I no longer use prescribed narcotics. I now use opioids as prescribed.

    Thanks for your post. I had no idea about the distinction or definitions. I definitely knew about the negative connotation. Unfortunately, I think the word "Opioid" sounds too much like "Opium", (Duh!), and that also has a negative connotation. However, I'm all in favor of being more accurate.

    Thanks again!
  • Things that make you go HMMM.....

    Thought about it. No thanks. I will keep my "meds" that I have been using.

    I don't use "Narcotics" or "Opioids"- people who I believe use the term is the MD's, pharmacy's and the Media. Not the actual pain patients in everyday conversation.

    Just my $ 0.02

  • I'm not expecting any big, sweeping changes in the way people refer to their meds as a result my measly little post/rant. It's just something that's been in the back of my mind for a while now, and I was curious if anyone else felt the same way. Personally I don't like the negative connotations that come with "narcotic" (which can refer to any drug that causes stupor or intoxication, really - especially illegal ones!). "Opioid" may not be free of stigma, but at least it is accurate and specific.
  • dilaurodilauro ConnecticutPosts: 9,856
    My doctors have generally referred to the medications I am taking as Narcotics. This was the wording that was used on pain contracts and is the reason why I need to see my Physiatrist at least every 30 days and have blood work done every 60 days.

    The hospital pharmacy I use generally refers to my medications (Opana) as strong analgesics. That got me looking for definitions:

    Drug or medicine given to reduce pain without the loss of consciousness. Many refer to this as painkiller medication.
    They can be mild as with Aspirin, Tylenols, Ibuprofen, and stronger as with Morphines, Oxycodone, Hydrocodone (listed as narcotic drugs)

    Drug that caues insensibility or stupor. A drug which is subject to regulatory restrictions.

    A synthetic narcotic that resembles the naturally occurring opiates. Opiate drugs are narcotic sedatives that depress activity of the central nervous system, reduce pain and induce sleep.

    I went to several online Medical and Pharmacy related sites and came up with the same basic definitions.

    I just called one of my friends who is a pharmacist , asked him this question... His response was
    We call them pain killers This way, he said, it does shun away from the word narcotic, which he felt brings up the image of a drug addict on the street, and from opiod, which people just think of as Opium. Looking at all the definitions,
    I think the term Analgesic would work fine, but there is such a large range in those medications.

    You know, after reading all of this, I am not sure what I can call the medications I use. Hmm, I think
    painkillers sounds the easiest.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • You have a good point, Huggy. I'm doing a presentation at our local college next week - educating up and coming nurses on the impacts of chronic pain. One thing that the instructor has asked me to emphasize is that medications MUST be given when needed. I'm going to add your two bits to my little lecture, if you don't mind; I have a few good quotes that I use from a nursing manual, and I really like your suggestion of avoiding the word "narcotics".

    Good point!

  • Huggy, thanks for highlighting something that I think is a definite source of problem for anyone suffering from spinal issues. The terms and phrases we use to describe ourselves, our pain and our medications (as you pointed out nicely).

    I tried to discuss this quite a while back and it ruffled more feathers than I thought and was quite surprising to me. What I am primarily referring to are the terms we use to describe ourselves or others suffering from spinal difficulties. Now I know many like having these terms to tag themselves with (some say it helps them deal with the reality of their injuries) and I am not trying to stir up a heated debate or insinuate anything towards anyone.

    What I am referring to are using terms like "spiney, neckie, lumbie, cervie". When I hear or read them, I get the image of someone talking to a small child trying to "sooth their boo boo". I can only imagine what it sounds like to someone "normal" or to our docs. My wonder is, even if we don't use the terms when speaking to others outside of this forum, are we making ourselves unknowingly represent our problems in a childish manner? Is this effecting the response we get from others as well as our doctors?

    So basically if the term "narcotic" promotes the image of "drug abuser", what sort of image does "spiney" promote?

  • Huggy,
    If we are to be assessed positively then we do ourselves a disservice in using a negative term that others less able to disseminate the difference between our clinical need and others. Although we use terminology pertinent to our understanding, it is important not to infer a perception of need, we have to describe our status in those terms that others understand and not reduce it to a known epithet only understood within this community, any group has a norming and forming process that may well be a language in itself only known to those within the group, we may understand the concept, we inadvertently segregate ourselves from those wishing to help us and may well have to use a terminology that although is not ideal does measure what the pain feels like to us as individuals. Our preference to use the 1-10 scale can provided an insight into how we measure the pain on a personal level and the figures do not represent the gravity of the pain itself, only our perception of its collective impact, a 10 pain does sometimes, say more about the individual than the pain itself and it is what it means to you than needs addressing.

    It is always a balance of presenting our collective needs and using a measure and words that we feel are appropriate, it was suggested recently that pain groups use selective language unique to our status.

    Recognition of pain and all its difficulties has taken considerable time to be viewed sympathetically, we are all learning to represent ourselves in a more favourable and helpful dimension, any change that assists our potential, rather than perception of unwarranted need has to be encouraged.

    In reality the desire to change any concept of disability as a descriptor, will not alter those opinions, although we can now all think of a more constructive word, no modification will deter those who envisage any group as inferior will be swayed in how they are described, the discrepancy is in them, not in what word is chosen.

    Take care.

  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    I agree with you. I like to keep it simple for myself and others.........Meds.
    Thanks for your insight.
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Thanks to all of you for your thoughtful responses. I like Ron's suggestion of 'analgesic' or 'pain killer'. I will write more when I am more alert - I have just taken a Zanaflex and keep nodding off. I've been writing this sentence for the last fifteen minutes! I keep dozing off and then suddenly jerking awake when my nose nearly splats against my keyboard. Thanks again, everyone, for your thoughts.
  • Hi Huggy,

    Don't think I've used the word but can see your point. What you may not understand is that many if not most people on this board are not medical professionals and are just trying to communicate with each other. What makes you "cringe" may not mean a thing to many people here. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • I probably use the word being a former nurse as we had to 'count the narcotics' at the end of each shift. So, narcotics does not send negatives vibes to me, but I do tend to say the word "meds" when speakiing of my narcotic analgesics!...or if it's a friend or neighbor, I may say 'pain medication'. But that is it! Thanks for the insight and thoughts...had never looked at this word in this way before.
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