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Opioids
What are
opioids?
Opioids are
commonly prescribed because of their effective
analgesic, or pain-relieving, properties.
Medications that fall within this class - sometimes
referred to as narcotics - include morphine,
codeine, and related drugs. Morphine, for example,
is often used before or after surgery to alleviate
severe pain. Codeine, because it is less efficacious
than morphine, is used for milder pain. Other
examples of opioids that can be prescribed to
alleviate pain include oxycodone (OxyContin),
propoxyphene (Darvon), hydrocodone (Vicodin), and
hydromorphone (Dilaudid), as well as meperidine
(Demerol), which is used less often because of its
side effects. In addition to their pain-relieving
properties, some of these drugs - for example,
codeine and diphenoxylate (Lomotil) - can be used to
relieve coughs and diarrhea.
How do opioids affect
the brain and body?
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, they can block
the transmission of pain messages to the brain. In
addition, opioids can produce drowsiness, cause
constipation, and, depending upon the amount of drug
taken, depress respiration. Opioid drugs also can
cause euphoria by affecting the brain regions that
mediate what we perceive as pleasure.
What are the possible consequences
of opioid use and abuse?
Chronic use
of opioids can result in tolerance for the drugs,
which means that users must take higher doses to
achieve the same initial effects. Long-term use also
can lead to physical dependence and addiction - the
body adapts to the presence of the drug, and
withdrawal symptoms occur if use is reduced or
stopped. Symptoms of withdrawal include
restlessness, muscle and bone pain, insomnia,
diarrhea, vomiting, cold flashes with goose bumps
("cold turkey"), and involuntary leg
movements. Finally, taking a large single dose of an
opioid could cause severe respiratory depression
that can lead to death. Many studies have shown,
however, that properly managed medical use of opioid
analgesic drugs is safe and rarely causes clinical
addiction, defined as compulsive, often
uncontrollable use of drugs. Taken exactly as
prescribed, opioids can be used to manage pain
effectively.
Is it safe to use opioid drugs
with other medications?
Opioids are
safe to use with other drugs only under a
physician's supervision. Typically, they should not
be used with other substances that depress the
central nervous system, such as alcohol,
antihistamines, barbiturates, benzodiazepines, or
general anesthetics, as such a combination increases
the risk of life-threatening respiratory depression.
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