There are many different types of drugs used to treat back and
neck pain. These
drugs include narcotics and non-steroidal anti-inflammatory drugs (NSAIDs).
Although the terminology is not precisely correct, pain-relieving opioids are
often called narcotics, and they may be prescribed to treat acute pain (severe,
short-lived pain), post-operative pain and certain types of chronic pain. Sometimes
the treating physician will prescribe an NSAID with a narcotic to relieve pain
associated with inflammation.
Taking pain medication is a serious decision and the patient should be aware
of the possible side effects from a single drug taken as well as the dangers
of combining different medications. This is a decision that should be made with
the treating physician who knows the patient’s medical history.
The purpose of this article is to help patients understand what an opioid narcotic
is, how they work, the common side effects, and drug induced symptoms that may
warrant medical attention.
Opioids: Powerful Narcotic Drugs
Opioids have been used for centuries to relieve pain. Those opioids that are
derived from the seedpod of the poppy plant (papaver somniferum) are referred
to as opiates. Morphine and codeine are commonly known opiates derived from
opium. Other opioids include synthetics such as meperidine (Demerol) and chemicals
naturally found in the body, such as endorphin.
How Drugs Treat Pain
Opioids work to relieve pain in two ways. First, they attach to opioid receptors,
which are specific proteins on the surface of cells in the brain, spinal cord
and gastrointestinal tract. These drugs interfere and stop the transmission
of pain messages to the brain. Second, they work in the brain to alter the sensation
of pain. These drugs do not take the pain away, but they do reduce and alter
the patient’s perception of the pain.
Factors Affecting “Effect”
The effects of any drug depends on the amount taken at one time, the patient’s
past experience with the drug, and whether the drug is injected, administered
intravenously or taken orally. The patient’s psychological and emotional
stability may also affect the effect of the drug. Of course, combining drugs
with other opioids or alcohol can produce profound side effects. Some side effects
can be harmful or lethal.
Tolerance
Chronic opioid use may result in a tolerance to the drug. This means that higher
doses of the drug are needed to obtain the same initial pain relieving effects.
Some patients develop a cross tolerance, which means prolonged use of one opioid
may cause a tolerance to develop to all opioids.
Common Side Effects
All drugs cause side effects. Some are acceptable and others are bothersome
or even dangerous. Common side effects include euphoria, drowsiness, nausea,
vomiting, constipation, dilated pupils and respiratory depression. The patient
should always report side effects to the treating physician.
Withdrawal
The body adapts to the presence of an opioid. Withdrawal symptoms appear when
drug usage is reduced or abruptly stopped. Symptoms of withdrawal may begin
as early as a few hours after usage is dramatically lowered, and the symptoms
peak two to three days thereafter. Never alter the prescribed dosage or stop
an opioid without the treating physician’s knowledge and advice.
Withdrawal symptoms include a craving for the drug, restlessness, moodiness,
insomnia, yawning, abdominal cramps, diarrhea and goose bumps.
Conclusion
Pain is personal -- no two patients perceive pain in the same manner. This is
one reason why patient/physician communication is important to manage pain effectively.
There are hundreds of drugs and other treatments available to treat back and
neck pain. Managing pain does not have to be a solitary effort when patients
and physicians work together.
