What are Opioids?
Opioids are a family
of pain-relieving
medications. They may
also be called opiates,
narcotics, or strong
pain relievers. Here are
some common names:
hydrocodone (Vicodin®,
Lortab®); fentanyl
(Actiq®, (Duragesic®);
oxycodone
(OxyContin®,
Percocet®); morphine
(MS-Contin®),
meperidine (Demerol);
hydromorphone
(Dilaudid®);
oxymorphone
(Opana®), codeine
(Tylenol #3® and
#4®), methadone, and
buprenorphine.
Better Ways to Relieve Chronic Pain
Other methods have been shown to work well and are less hazardous –– and are more
likely to restore a satisfying everyday life. Some methods are medical treatments and some
are things you can do by yourself. Suffering can usually be greatly relieved by learning how the
nervous system works and by learning new skills.
Multi-disciplinary pain programs and organizations like the American Chronic Pain Association
(www.theacpa.org) teach many specific techniques that relieve discomfort. Mastering them
will allow you to soothe yourself and minimize the things that often make pain worse: stress,
inactivity, uncertainty, feeling powerless, being out of shape, boredom, fear, anger –– all the
normal human reactions to pain and life disruption. Combining several methods often works
the best.
Lack of Relief Despite High Doses Is a Signal It’s Time to Rethink
If your life is still on hold and your pain level is still high after months of opioid use, it’s
probably time to think about changing treatments. Your doctor may be able to prescribe
other treatments with fewer side effects to help you manage the pain while you learn
the self-care approaches that will help you get your life back on track.
You can ask your doctor to help you reduce or stop the opioids so you can see whether
you feel better overall. It can be dangerous as well as uncomfortable to do this rapidly
or without medical supervision, especially if you are on high doses or are taking more
than one medication. You may need a specialist in detoxification.
Long-term Opioid Use Can Actually Cause More Pain
Over time, opioids can actually heighten your sensitivity to pain, which makes you feel
worse. The brain may even start interpreting normal sensations as painful. The term for
this is “hyperalgesia.” This phenomenon has been seen in many people on prolonged
opioid therapy. In other words, the drugs have actually become a source of increased
pain. Often the best solution is to simply reduce or get off opioids entirely. After a
tapering process, people with hyperalgesia end up feeling better with less pain.
Daily Cycle of Withdrawal Symptoms Increases Suffering
If your body has become dependent on a narcotic drug, unpleasant symptoms appear
along with an increase in pain near the time of the next dose of your meds. This is called
withdrawal. Symptoms can include restlessness, irritability, muscle and bone pain,
insomnia, sweating, diarrhea, vomiting, and so on. The daily roller coaster of withdrawal
is especially difficult for those who routinely take opioids many times a day. Over time,
the frequent dosing schedule may teach the brain to create painful and distressing
sensations as a way to make sure it gets the next dose.
Sexual Dysfunction
Research has shown that long-term use of opioids shrinks the glands that make sex
hormones. Long-term exposure to opioids can cause sexual dysfunction including both
reduced desire and performance. Changes in sex hormones (testosterone and estrogen)
may cause other effects, including breast enlargement in men, fatigue and depression.
Other Side Effects of Long Term Opioids
Opioids have effects on many bodily functions. They can affect judgment, decision
making and moods. Opioids can cause sedation, drowsiness and may cause confusion,
especially when the medication is being started or the dose has been increased.
Opioids can affect balance and increase the risk of falls. They also disturb the quality