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The American Academy of Neurology warns doctors about the use of opioids or narcotics to manage chronic pain that is not due to cancer. Its policy statement offers guidelines on best practices regarding opioid doses, screening, and monitoring patients.

Pain is one of the major reasons why people seek treatment. It is a symptom associated with many conditions, including trauma, acute illnesses, and chronic disease. It may be characterized as acute or chronic (long-lasting), although others experience intermittent (on-and-off) pain. Pain may go away when the source is successfully treated, but in some conditions, pain may be associated with a disease that is incurable (such as some cancers) or intractable (such as fibromyalgia). In many cases, the patient may suffer from progressive pain, which does not seem to get better with ordinary treatments. This can significantly reduce their quality of life as well as their productivity.

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There are many medications people use to relieve pain, including over-the-counter drugs and those prescribed by their doctors. For people who suffer from chronic pain that is moderate to severe in intensity, one type of pain reliever may not work. Sometimes, they need higher doses to feel better. In these cases, doctors may prescribe opioids or narcotic medications, which are known to be effective, to put their patients back on their feet and be able to live a more productive life.

The American Academy of Neurology, however, has recently released a new policy statement against the use of narcotics (opioids) for the relief of chronic, non-cancer pain.

The sharp increase in the number of deaths related to opioid overdose has led many experts to warn practitioners that the risks of using opioids far outweigh the benefits in non-cancer conditions characterized by chronic pain such as fibromyalgia, headache, and lower back pain.

How Narcotics Work

People often associate narcotics with illicit drugs, which some people use for recreational purposes. However, “narcotics”, which is derived from the Greek word "narke," means "numbness," refers to substances that induce stupor, sleep, or insensibility, and are commonly medically prescribed as opioids or opioid derivatives. They come from opium, which consists of a mixture of alkaloids extracted from the poppy plant (Papaver somniferum). The natural derivatives of these alkaloids are called opiates, and these include codeine, morphine, and heroin. Synthetic opiate derivatives include oxycodone, hydrocodone, methadone, fentanyl, and hydromorphone.

Opioid drugs are used in different forms, such as pills, liquids, and suckers, which are taken by mouth, and injections, skin patches, and suppositories. These drugs are often prescribed to reduce moderate to severe pain that is not relieved by other pain medicationssuch as non-steroidal anti-inflammatory drugs (NSAIDs).

Opioid analgesics work by suppressing your pain perception and calming your emotional response to the pain.

See Also: Dilemma Of Opioid Drugs

They reduce the amount of pain signals sent by your nervous system as well as your brain's reaction to these pain signals.

Opioids are very effective in relieving moderate to severe pain, but they are often prescribed for short-term use in patients who are suffering from pain due to various conditions, such as cancer, which may not respond to other forms of pain treatments. However, like other drugs, opioids have many potential side effects. These include nausea, vomiting, constipation, drowsiness, and dizziness. Serious, long-term side effects of include decreased immune response, decreased sex hormone production, increased risk for falls and fractures in elderly patients, breathing problems during sleep, irregularities in heart rate, opioid overdose, unintentional poisoning, and death.

Continue reading after recommendations

  • Medpage Today. AAN Warns Against Opioids in Chronic Noncancer Pain. http://www.medpagetoday.com/PainManagement/PainManagement/47871?
  • Medscape. Opioid Toxicity. http://emedicine.medscape.com/article/815784-overview#a0101
  • WebMD. Opiate Pain Relievers for Chronic Pain. http://www.webmd.com/pain-management/opioid-analgesics-for-chronic-pain
  • Neurology. Opioids for chronic noncancer pain. http://www.neurology.org/content/83/14/1277.full
  • Photo courtesy of Eric Norris by Flickr: www.flickr.com/photos/sfxeric/3964596491
  • www.medpagetoday.com
  • medscape.com
  • www.webmd.com
  • www.neurology.org