The relief brought by narcotic (opioid) pain medications can make life much more comfortable for patients recovering from surgery and as a treatment for severe back pain.
Every medication has benefits and drawbacks, however. The powerful effects of narcotic pain medications call for special care to avoid or watch out for potential problems, including:
- Accidental overdose
- Dependence on medication
- Side effects, including breathing problems
- A need for increasingly stronger doses
While all medications should be used as directed, this is especially important with narcotic pain medications. Pain medication usually has a stronger effect on older adults, so extra caution is advised for older individuals.
Avoiding an Accidental Overdose
The U.S. Centers for Disease Control and Prevention has warned of an epidemic of fatal prescription painkiller overdoses, including narcotic pain medication. A single, high-dose tablet can cause fatal breathing problems.
These precautions are advised to prevent an overdose:
- Avoid taking a second medication that causes sleepiness, such as another narcotic, anti-anxiety medication, or a muscle relaxer. Alcohol should be avoided as well.
- Keep the doctor informed by providing a thorough medical history, including any addiction problems.
- To be certain of the correct dose, liquid medication should be measured using the dropper provided, a marked dosing cup, oral syringe, or measuring spoon, rather than a spoon designed for the table. Spoons used for food vary in size.
- Tablets and capsules must be swallowed whole, and not moistened, crushed, or cut. Doing so can allow the patient to ingest a dangerous amount of medication.
- If a medication is not working, the doctor should be contacted. The dose should never be increased without a doctor’s approval.
- Ask the doctor about interactions with food. Some foods, such as grapefruit or grapefruit juice, increase the amount of medication the body retains.
Signs of an overdose include blue lips and a weak pulse or heartbeat. Sometimes the person makes gurgling sounds. The individual should go immediately to an emergency room, where fast-acting medication may be life-saving.
Opioid Common Side Effects
Side effects of narcotic pain medications tend to increase with higher doses. These are typical side effects:
- Dry mouth
- Upset stomach
- Lung and heart problems
- Sleep apnea
The doctor should be informed of any side effects. In some cases, the doctor might suggest the patient switch to a different medication or suggest ways to avoid or minimize the side effects.
Opioid Dependence and Withdrawal
Narcotic pain relievers are ideally taken for short-term pain relief, and addiction is unlikely with short-term use (e.g. up to one or two weeks). Individuals who take narcotic pain medication over a longer period may become physically dependent on the medication, however.
Dependence should not be confused with addiction. Dependence is a physiological response. With addiction, however, there is not just the physical response to the medication but also a craving for the “high” it provides, and a desire to continue taking it no matter what kind of problems the medication causes in daily life.
Stopping the medication after long-term use must be done carefully to avoid withdrawal symptoms. Tapering off the medication gradually, in close consultation with the doctor, is best. Typical symptoms of withdrawal include fever, chills, and sweating. Withdrawal symptoms are more likely in those who have been using a narcotic pain reliever at high doses.
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As time goes on, the patient’s body will become more tolerant of the drug and require a higher dose to get the same pain relief as before. If an individual stays on the medication long enough, he or she may reach the stage where even high doses of the medication don’t ease the pain. The doctor may discuss non-narcotic strategies to replace or supplement narcotic pain medications at this point.
In some situations, continuing to take narcotic pain medication can actually make the individual feel pain from things that normally would not hurt.
Long-term use of narcotic pain medication has certain side effects. The body’s tolerance for narcotic pain medication can linger long after the medication is stopped. Individuals who have built up a tolerance may encounter difficulty getting pain relief if a new, unrelated source of pain occurs, such as a severe injury or surgery that would typically be treated with narcotic pain medication.