Narcotics (opioids) are a family of medications that includes codeine, fentanyl, oxycodone, tramadol, morphine, pethidine and heroin. Narcotics were originally made from opium poppies. Some narcotics are still made from poppies, while others are made in a laboratory.
Narcotics are useful for short term pain – like the pain for the first few days after an operation, or on the worst day of a period. When used in this way, they rarely cause problems. They are a normal part of the care provided in a hospital after an operation and usually stopped within a few days.
Narcotics should be avoided for long term pain – like back or pelvic pain that has been present for weeks, months or even more. This is when they cause problems.
Why is using these medications regularly a concern?
We now know that there is a big difference between using these drugs for a few days for a short term pain, and using them regularly for a longer term pain. When used regularly, several things happen:
- They don’t work as well. Our bodies get used to the medication and need larger and larger doses, often with less and less effect on pain.
- They worsen pain. Narcotics might help pain when first taken, but over time they sensitise nerve pathways, making pain worse.
- They are addictive. These drugs can change our mood – making us feel worse if we stop them.
- They are dangerous. Drug overdose deaths now outnumber road fatalities in Australia. Often death was an accident and narcotics prescribed for pain are more likely to be part of the problem than illegal drugs such as heroin.
- They have side effects. Opioids interfere with clear thinking, cause constipation, and increase nausea.
Getting off opioids
The following video looks at some of the issues around regular narcotic (opioid) use, and better ways of managing long term pain.
This video was created by the Hunter Integrated Pain Service for those suffering from chronic pain. You can visit their website at http://www.hnehealth.nsw.gov.au/pain
Darnell BD, Stacey MD, Chou MD. Medical and psychological risks and consequences of long-term opioid therapy in women. Pain Med 2012; 13: 1181–1211.
Brainman and The Hunter Integrated Pain Service. Understanding Pain: Brainman stops his opioids. Youtube 2014 <https://www.youtube.com/watch?v=MI1myFQPdCE&list=UUAfjSufXOnORMLMtSid6CQQ>