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Pain medications - narcotics

Alternative Names

Painkillers; Drugs for pain; Analgesics; Opioids

Information

Narcotics are also called opioid pain relievers. They are used only for pain that is severe and is not helped by other types of painkillers. When used carefully and under a health care provider's direct care, these drugs can be effective at reducing pain.

Narcotics work by binding to receptors in the brain, which blocks the feeling of pain.

You should not use a narcotic drug for more than 3 to 4 months, unless you are under direct care of your provider.

NAMES OF NARCOTICS

  • Codeine
  • Fentanyl -- available as a patch
  • Hydrocodone
  • Hydromorphone
  • Meperidine
  • Morphine
  • Oxycodone
  • Tramadol

TAKING NARCOTICS

These drugs can be abused and habit-forming. They have been associated with accidental overdose deaths. Always take narcotics as prescribed. Your provider may suggest that you take your medicine only when you feel pain.

Or, your doctor may suggest taking a narcotic on a regular schedule. Allowing the medicine to wear off before taking more of it can make the pain difficult to control.

Taking narcotics to control the pain of cancer or other medical problems does not itself lead to dependence.

Store narcotics safely and securely in your home.

You may need a pain specialist to help you manage long-term pain.

SIDE EFFECTS OF NARCOTICS

Drowsiness and impaired judgment often occur with these medicines. When taking a narcotic, do not drink alcohol, drive, or operate heavy machinery.

You can relieve itching by reducing the dose or talking to your doctor about switching medicines.

To help with constipation, drink more fluids, get more exercise, eat foods with extra fiber, and use stool softeners.

If nausea or vomiting occur, try taking the narcotic with food.

Withdrawal symptoms are common when you stop taking a narcotic. Symptoms include strong desire for the medicine (craving), yawning, insomnia, restlessness, mood swings, or diarrhea. To prevent withdrawal symptoms, your doctor may recommend you gradually lower the dosage over time.

References

Brenner GM, Stevens CW. Opioid analgesics and antagonists. In: Brenner GM, Stevens CW. Pharmacology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 23.

Issa M, Celestin J, Wasan AD. Issues associated with opioid use. In: Benzon HT, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW, eds. Practical Management of Pain. 5th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 51.

Lee MC, Abrahams M. Pain and analgesics. In: Bennett PN, Brown MJ, Sharma P. Clinical Pharmacology. 11th ed. Philadelphia, PA: Elsevier; 2012:chap 18.


Review Date: 5/3/2015
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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