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Opioids Are Pain Relievers
Opioids are commonly prescribed because
of their effective analgesic or pain relieving properties.
Many studies have shown that properly managed medical
use of opioid analgesic drugs is safe and rarely causes
clinical addiction, which is defined as compulsive,
often uncontrollable use. Taken exactly as prescribed,
opioids can be used to manage pain effectively.
Among the drugs that fall within this
class - sometimes referred to as narcotics - are morphine,
codeine, and related drugs. Morphine is often used before
or after surgery to alleviate severe pain. Codeine is
used for milder pain. Other examples of opioids that
can be prescribed to alleviate pain include oxycodone
(OxyContin-an
oral, controlled release form of the drug); propoxyphene
(Darvon); hydrocodone (Vicodin);
hydromorphone (Dilaudid); and meperidine
(Demerol), which is used less often because of its side
effects. In addition to their effective pain relieving
properties, some of these drugs can be used to relieve
severe diarrhea (Lomotil, for example, which is diphenoxylate)
or severe coughs (codeine).
Opioids act by attaching to specific
proteins called opioid receptors, which are found in
the brain, spinal cord, and gastrointestinal tract.
When these drugs attach to certain opioid receptors
in the brain and spinal cord they can effectively block
the transmission of pain messages to the brain.
In addition to relieving pain, opioid
drugs can affect regions of the brain that mediate what
we perceive as pleasure, resulting in the initial euphoria
that many opioids produce. They can also produce drowsiness,
cause constipation, and, depending upon the amount of
drug taken, depress breathing. Taking a large single
dose could cause severe respiratory depression or be
fatal.
Opioids may interact with other drugs
and are only safe to use with other drugs under a physician's
supervision. Typically, they should not be used with
substances such as alcohol, antihistamines, barbiturates,
or benzodiazepines. These drugs slow down breathing,
and their combined effects could risk life-threatening
respiratory depression.
Chronic use of opioids can result in
tolerance to the drugs so that higher doses must be
taken to obtain the same initial effects. Long-term
use also can lead to physical dependence - the body
adapts to the presence of the drug and withdrawal symptoms
occur if use is reduced abruptly.
Symptoms of withdrawal can include restlessness,
muscle and bone pain, insomnia, diarrhea, vomiting,
cold flashes with goose bumps ("cold turkey"),
and involuntary leg movements.
Options for effectively treating addiction
to prescription opioids are drawn from experience and
research on treating heroin addiction. Some examples
follow.
Source: NAIDA
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