Meant to help manage chronic and moderate-to-severe pain, opiates are a class of pain relieving drugs, or analgesics, often more powerful than what can be obtained over-the-counter. Due to the strength of drugs such as fentanyl, codeine, and morphine, and the high risk of developing a physical and mental dependency, use is typically limited to a short period of time.
Opiates and Opioids
The term “opiates” is often used to mean any drug that can fits within either category. The term “opiates” originally referred to natural drugs derived from the opium poppy, but has since expanded to include full and semi-synthetic drugs. “Opioids” are the synthetic or semi-synthetic drugs within this class.
Managing Severe Pain
Analgesic opiates are often prescribed to manage pain that’s not responding to home remedies. Such medications are meant to be used until a source of pain can be determined and other treatment options can be recommended.
Easing Chronic Pain
Patients with conditions that result in chronic pain, like some forms of cancer and diabetes-related nerve damage (neuropathy), may be given opiates to reduce pain to a tolerable level. Opiates for chronic pain not responding to other treatment options are often used on a long-term basis.
Depending on the type of surgery, post-operative pain can sometimes be severe enough to warrant the use of opiates. In this case, use is also meant to be temporary until any discomfort from surgery eases or goes away altogether.
How Opiates Work
Opiates relieve pain by working within the brain and spinal cord to target special nerves that control how pain is interpreted and how pain signals are delivered. In the spinal cord, opiates stop pain signals from being sent to the brain in what is known as analgesic effect.
Possible Side Effects
Some patients experience an allergic reaction to some opiates, with symptoms that can range from hives and rash to difficulty breathing and wheezing. Common side effects include:
- Nausea and vomiting
- Difficulty sleeping
- Vision issues
- General weakness or fatigue
- Skin tingling or redness
If opioids are used for a long enough period of time, a point may be reached where receptors are no longer responsive to the medication. When tolerance develops, patients often need a higher dose to receive the same degree of relief. Since pain is subjective, it can be difficult to determine whether or not an increased dosage is necessary. Some patients may develop hyperalgesia, a heightened sensitivity to pain, from prolonged use of opioids that continues regardless of dosage.
Monitoring Opioid Use
When use is carefully monitored, opioids can serve a useful purpose for many patients. However, it’s often a delicate balance between determining the appropriate dosage and preventing physical and psychological dependence from developing. Consequently, opioid drugs aren’t meant for use by patients with minimal or occasional pain.
More than 200 million prescriptions for opiates are written each year. While often prescribed to treat ligament pain, the potency of opiates makes the risk of addiction high. A growing number of doctors are being more cautious with prescribing opiate pain relievers or opting for less-addictive medications, including non-steroidal anti-inflammatory drugs (NSAIDs) and over-the-counter acetaminophen.