What Are the Side Effects of Avinza for Back Pain?

  • Medical Author:
    Standiford Helm II, MD

    Dr. Helm has been practicing interventional pain management since 1982. Dr. Helm is a diplomate of the American Board of Anesthesiology with subspecialty certification in Pain Medicine and of the American Board of Pain Medicine. Dr. Helm is a Fellow of Interventional Pain Practice (FIPP), the only certifying agency which tests the ability to perform interventional pain procedures. Dr. Helm is also an examiner for FIPP.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Ask the experts

I have had 3 spinal fusions, and am taking 120mg of Avinza for long term pain relief. What are the long-term consequences of using Avinza?

Doctor's response

We know less than we would like about the long-term effects of narcotics. We do know that they are safe in terms of not damaging the various organs, such as the kidneys, liver or stomach; we limit the amount of Vicodin you take not because of the narcotic, but because of the acetaminophen. However, there are some long-term effects of opioids, including Avinza (morphine), which do occur.

Treatment depends in part upon the cause of the neuropathy. In general, physicians prescribe drugs that alter the processing of pain information in the spinal cord. Examples would include antidepressants, anti-epilepsy drugs, certain alpha-2 agonists, and opioids.

Opioids in men can cause a decrease in testosterone, so that if you are taking opioids and have a decreased sex drive, testosterone levels should be checked. Long-term use of opioids can be associated with tolerance to the drug or even hyperalgesia, in which the opioids themselves cause the pain to become worse. There is also some evidence to suggest that opioids may decrease immune function. The clinical importance of this evidence has not yet been fully evaluated.

Finally, there is always the question of the long-term effects on the ability to think clearly and to function. The evidence is contradictory on this point; most pain physicians feel that opioids should be used in a way that allows clear thinking and functioning. In short, doctors believe that opioids are safe for long-term use, but there are many questions which still must be more fully investigated.

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care


"Subacute and chronic low back pain: Nonsurgical interventional treatment"

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Reviewed on 8/18/2017

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