Considered as one among the more popular pain-relieving medications, opioids offer proven relief in controlling acute pain. It is also used frequently post-surgery to help patients deal with the pain during the procedures. When taken as per the prescription and recommendations, opioids are considered as relatively safe. However, when the medications are not taken as per medical advice, there is every possibility of adverse outcomes. The following sub sections offer a detailed view of the medication, its mechanism of action and possible side effects of opioids.

Overview of opioids

Prescription medications typically recommended for short term use, opioids are pain relievers, made either from plant sources such as the poppy plant, or can also be synthetic in nature. A common example of plant-based opioids is morphine, while an example of synthetic products includes fentanyl. The drugs are also recommended for use by cancer patients, and patients undergoing palliative care; in such instances, the medications may be given for a longer period. The medication is known to work by bringing down pain sensations through interruption of the pain signaling by the nerves that transmit stimuli between the brain and the body. By working on the receptors in the brain, the individual on opioids may experience lesser pain, or may have different feelings when the pain stimuli are transmitted. One of the reasons for the unenviable demand of opioids is the illicit business of recreational drugs that are sourced in an illegitimate manner.

Available either as injections, tablets, or patches, opioids are potent in desired outcomes and are often prescribed when other pain relief measures fail. One of the reasons for the drug being labelled as dangerous in certain circumstances is the mechanism of action that has dose dependent different effects. For instance, when the dosage is on the lower side opioids have the effect of making users drowsy, thereby helping overcome the sensation of pain. However, when taken in larger dosages, opioids are known to have an impact on heart beat rate. Depending on various factors, and the dosage this could sometimes, unfortunately result in fatalities.

Another reason for the apprehensions surrounding opioids is the high probability of addiction. Due to the feelings of pleasure experienced when on opioids, the patient may get addicted to the medication, and this may sometimes also result in possible withdrawal symptoms when stopped. It is absolutely necessary to diligently follow the recommendations and instructions of the treating specialist with respect to the dosage and intake schedule. It is also critically important to intimate the doctor of other medications and supplements in use. This will help eliminate the possible of interactions that can turn serious in nature.

Possibility of overdose from opioids

There are multiple instances of patients suffering from overdose symptoms. This is because of the attempt of patients to achieve better pain relief with doses that are beyond the prescribed doses. Overdose is more frequently reported when the medications (in different forms) are abused and illicitly used for pleasure and as recreational drugs.  There are clear indications of opioids overdose, and individuals are cautioned to closely monitor the patient for any signs of overdose symptoms. This includes difficulty in breathing and vomiting apart from the patient suddenly turning unresponsive. Naloxone is considered as an effective option to help patients deal with overdose. Naloxone works by blocking the opioid receptors temporarily, and this action prevents the drugs from delivering the outcomes.

Typical uses of opioids
Opioids are prescribed by doctors for certain specific conditions. For instance, patients suffering from pain due to a surgical or medical procedure may require short term pain relief medication. Similarly, cancer patients with chronic pain that may often extend to more than three months is also treated with opioids. The medications are also prescribed for use by patients undergoing palliative care in a hospice. Medications are also used as part of therapy to wean away addicts from drugs. It is important to add that opioids, while being effective for cancer patients, is not considered as an effective treatment option for chronic pain in non-cancerous conditions.

Categories of individuals at higher risk of side effects of opioids

While the risk of opioids and side effects are common to all users, certain categories of users are at higher risk. This includes patients with existing lung ailments or complications. Individuals who initially take opioids are likely to experience undesirable effects of the medication. Similarly, patients who are recommended an increase in dosage are also likely to experience stronger or potent effects. Aged patients are also at risk of experiencing undesirable effects from opioids.

Precautions that need to be taken when on opioids

Individuals on opioids are to take certain precautions due to the mechanism of action of the medication and the possible outcomes. For instance, as opioids are known to cause drowsiness, individuals are advised not to take up responsibilities that involve operating of heavy machinery. Similarly, driving or working in hazardous environments, or tasks that require the individual to be alert with fast reflexes are not to be taken up, as the medication can have a negative impact on capabilities. Many road accidents are attributed to drowsiness that could be as a result of natural fatigue, overwork or drug induced drowsiness. The risks increase manifold when the medication or recreational drug is combined with other intoxicants.

Commonly reported withdrawal symptoms of opioids

As mentioned earlier, there is the possibility of patients experiencing withdrawal symptoms after discontinuing the medication, especially if it has been used for a long stretch. This is especially true in the case of patients on the medication for more than a fortnight. This is also true in the case of patients who abruptly discontinue the intake. It may be necessary for doctors to slowly taper down the dosage, before fully stopping the medication. There are clear tell-tale symptoms of withdrawal and patients or caregivers can easily identify the symptoms and take necessary remedial measures. For instance, the patient may break out into abnormal sweating after discontinuing the medication. Other symptoms include hot flushes, cold flushes that are unusual in occurrence. Joints are likely to pain for no explained reason; similarly, there is also the possibility of muscle pain.

The individual may experience running nose, while others are known to experience bouts of diarrhea, and abdominal cramps. The patient is also likely to experience feelings of nausea, while some are known to end up with throbbing headaches. An unusual effect linked to withdrawal symptoms is the bristling of hair or formation of goosebumps with no attributable condition or feeling. The pupils may also appear dilated in nature, while some patients are known to turn agitated in nature.

As mentioned above, there is the possibility of change in heart rate as a side effect, and this could also be experienced by patients with withdrawal symptoms. The individual may also experience anxiety, or may have feelings if insomnia, apart from a constant or deep craving for opioids. The ideal course of action for managing withdrawal symptoms is to modify the dosage and ensure that the medications are tapered off to prevent unwanted effects.

Commonly documented risks and side effects of opioids

There are clear risks and possible undesirable outcomes linked to opioids, and the same has been clearly highlighted by the FDA. For instance, medications with benzodiazepines or cough medications that have a suppressant action on the CNS, when combined with opioids may trigger adverse outcomes. The effects included difficulty in breathing and in certain rare circumstances, death. This makes it necessary for patients undergoing treatment for seizures, anxiety disorders or insomnia to stop the intake of conflicting medications to prevent adverse outcomes. In the event that the conditions warrant intake of both the medications, then it may be necessary to stagger the intake or the alter the dosage accordingly. By altering the dosage of either of the medications or both the medications, it is possible to lessen the effects to a certain extent, so as to prevent serious or adverse outcomes.

There are other clear risks linked to taking opioids with alcohol. This is a relatively common occurrence among individuals looking for the proverbial high. Substance abuse involving opioids, often involves combining the medication with intoxicants such as alcohol. There is the possibility of this triggering serious or adverse conditions in the patients.

Undesirable effects of the medication

All medications come with the possibility of side effects and opioids are no exception. The actual effects differ from person to person, and is determined by various factors, such as the dosage, the frequency of intake, the condition being managed, overall health, other ailments, and medications in use that may cause interactions. A small section of users is unlikely to experience any effects whatsoever, when the medications are taken in the prescribed doses. Effects that are common with opioid use includes dizziness, drowsiness, respiratory depression and constipation. There are other symptoms of unwanted effects such as delay in gastric emptying, apart from conditions such as hyperalgesia. The patient is also likely to end up with immunologic and hormonal dysfunction, apart from rigidity in the muscles.

Constipation is considered as one of the most common outcomes from opioids. This is precisely one of the reasons for medications such as tramadol to be used in healthcare settings. This will prevent the patient from undergoing outcomes that may become difficult to handle in home settings. Apart from constipation, nausea is also known to have a very high incidence rate among patients on the medication. In certain circumstances, it may be necessary to discontinue use of opioids due to the feelings of nausea and constipation. Research on other medications or lines of treatment are underway to determine if other treatment regimen can help reduce the effects.

Categorization of opiates and opioids

There is the possibility of confusion about the difference between opiates and opioids. Though the outcome of both is similar, there is a small difference between the two. Opiates are derived from natural substances, while opioids are derived synthetically. To define clearly, opiates are made from poppy plants that are naturally occurring, and the end products are opium, morphine and heroin etc. Opioids are derived from the poppy plant synthetically, with the active ingredients created chemically in safe laboratories.

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