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- What are narcotic pain medications (opioids, analgesics)?
- What are the side effects of pain medications?
- Are pain medications addictive?
- What are the withdrawal symptoms of addiction to pain medications?
- Which drugs and supplements interact with pain medications?
- Can I take pain medications if I'm pregnant or breastfeeding?
- List of examples narcotic pain medication brand names available in the US
- Where can I get help and support for pain medication addiction?
- What forms of pain medications are available?
What are narcotic pain medications (opioids, analgesics)?
Narcotic medications are used for treating moderate to severe pain.
Narcotic pain medications attach to receptors on nerves in the brain that increase the threshold to pain (i.e., the amount of stimulation it takes to feel pain), and reduce the perception of pain (the perceived importance of the pain). Most men and women take narcotic pain medication for short-periods until the pain lessens or goes away. Some adults have chronic pain, which requires proper pain management since long term use can lead to drug addiction and tolerance (the need for increasing doses). Narcotic pain medication have a high potential for misuse, abuse, and diversion to supsceptible.
The CDC has recently developed and published the CDC Guideline for Prescribing Opioids for Chronic Pain to provide recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings in 2016.
What are the side effects of pain medications?
Common side effects of narcotic analgesics include:
Severe side effects of narcotic analgesics include:
Are pain medications addictive?
Prescription narcotics are the most commonly abused opioids and the leading cause of opioid-related overdose in the U.S. Taking any opioid - even prescription opioids - for long periods can result in dependence, which means if you suddenly stop taking the drug you will have withdrawal symptoms. A small percentage of people taking narcotics will become addicted. Addiction is a chronic disease characterized by:
- Overpowering cravings, with compulsive drug use.
- The inability to control drug use, and continue to use them despite harm to the self or others.
Opioid addiction can result in an increased chance of :
- Serious heart infections (endocarditis)
- Narcotic bowel syndrome
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What are the withdrawal symptoms of addiction to pain medications?
Signs and symptoms of opioid withdrawal include:
- Abdominal cramps
- Flu-like symptoms (fever, sweating, shivering, runny nose)
- Goosebumps (piloerection)
- Dilated pupils
- High blood pressure (hypertension)
- Fast heart rate
- Sleep problems (insomnia)
- Restless leg syndrome (RLS)
- Tremors (shaking)
- Loss of appetite
- Joint or muscle pain
- Leg cramps
Which drugs and supplements interact with pain medications?
- phenelzine (Nardil)
- selegiline (Zelapar, Emsam, and Eldepryl)
- tranylcypromine (Parnate)
- procarbazine (Matulane)
- rasagiline (Azilect)
- isocarboxazid (Marplan)
The discontinuation and initiation of narcotics and MAO inhibitors should be separated by at least 14 days.
Narcotics should be used with caution with these central nervous system depressants because of an increased risk of respiratory depression, low blood pressure, sedation, and in severe cases, coma and death.
- alprazolam (Xanax)
- clonazepam (Klonopin)
- diazepam (Valium)
- zolpidem (Ambien)
- zaleplon (Sonata) and alcohol because of increased risks of respiratory depression,
- Low blood pressure
- In severe cases, coma and death
Narcotic pain medications should be used with caution with medications that alter liver enzymes that affect the elimination of narcotic analgesics because levels of narcotic analgesics can increase or decrease in the body and thereby affect their therapeutic effectiveness.
Naloxone (Narcan) is a medication used to reverse the effects of narcotics, especially in acute overdose situations. In some states, Narcan is available via a prescription to the public for use in high-risk situations (such as having a close family member with a recent history of narcotic addiction or overdose).
Can I take pain medications if I'm pregnant or breastfeeding?
There are no adequate studies of narcotic pain drugs to determine if their use is safe and effective during pregnant women. Narcotic analgesics may pass through breast milk and affect the baby they should be avoided in females who are breastfeeding.
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List of examples narcotic pain medication brand names available in the US
Examples of narcotic analgesics are:
- hydrocodone (Zohydro ER, Vicodin, Lortab)
- oxycodone (OxyContin, Roxicodone, Percocet)
- methadone (Methadose, Diskets, Dolophine)
- hydromorphone (Dilaudid, Exalgo)
- morphine (Avinza, Kadian, MSIR, MS Contin)
- fentanyl (Actiq, Duragesic Sublimaze)
- oxymorphone (Opana)
- meperidine (Demerol)
- tramadol (Ultram, Ultracet, ConZip)
Where can I get help and support for pain medication addiction?
Narcotics Anonymous World Wide Services is a global community based organization with a multicultural membership.
What forms of pain medications are available?
Pain medications are available as:
- methadone as immediate-release tablets
- oxycodone and morphine extended-release tablets.
- morphine and hydrocodone are available as extended-release capsules.
- morphine as intravenous, subcutaneous, and intramuscular injections
- fentanyl oral lozenge (Actiq) and topical patch (Duragesic)
Narcotic analgesics (also called opioids) are medications prescribed to treat moderate to severe pain. Examples (list) include codeine, hydrocodone, oxycodone (OxyContin Roxicodone, Oxecta, Oxaydo, Xtampza ER, and Roxy bond), methadone (Dolophine; Methadone HCl Intensol; Methadose; Methadose Sugar-Free), morphine (Morphine ER, morphine injection (Astramorph, Duramorph, Infumorph, and Avinza), hydromorphone (Dilaudid, Dialudid-5, and Exalgo), fentanyl (Sublimaze, Actiq, Duragesic, and Fentora).
Side effects of narcotics include dry mouth, itching, addiction, headache, dizziness, constipation, and nausea. Drug interactions, dosing, and pregnancy and breastfeeding safety information are provided.
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Related Disease Conditions
Ankle Pain (Tendinitis)
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Lower Back Pain
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Acute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
Coccydynia (Tailbone Pain)
Coccydynia is an inflammation of the bony area (tailbone or coccyx) located between the buttocks. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. Pain is often worsened by sitting. There are many causes of tailbone pain that can mimic coccydynia including: fracture, pilonidal cysts, infection, and sciatica. Treatment methods include medication and rest.
Neck Pain (Cervical Pain)
Neck pain (cervical pain) may be caused by any number of disorders and diseases. Tenderness is another symptom of neck pain. Though treatment for neck pain really depends upon the cause, treatment typically may involve heat/ice application, traction, physical therapy, cortisone injection, topical anesthetic creams, and muscle relaxants.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Pain Management: Musculoskeletal Pain
Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is described in three stages: perimenopause, menopause, and postmenopause. However, not all women undergo natural menopause. Some women experience induced menopause as a result of surgery or medical treatments, such as chemotherapy and pelvic radiation therapy.
Cancer pain results from the tumor pressing on nerves or invading bones or organs. Cancer treatments like chemotherapy, radiation, or surgery can also cause pain. Over-the-counter pain relievers, prescription medications, radiation, biofeedback, and relaxation techniques are just some treatments for cancer pain.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Sacroiliac Joint Dysfunction (SI Joint Pain)
Sacroiliac joint (SI) dysfunction is a general term to reflect pain in the SI joints. Causes of SI joint pain include osteoarthritis, abnormal walking pattern, and disorders that can cause SI joint inflammation including gout, rheumatoid arthritis, psoriasis, and ankylosing spondylitis. Treatment includes oral medications, cortisone injections, and surgery.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
A broken foot is a common injury. There are 26 bones in the foot, and these bones can be broken (fractured) in a variety of ways. Signs and symptoms of a broken bone in the foot are pain, swelling, redness, bruising, and limping because the person is not able to walk on the affected foot. You can tell if you have a broken foot by medical examination that includes imaging studies. The healing and recovery time for a broken bone in the foot depends upon the type of fracture and the bones broken.
Shoulder and Neck Pain
Shoulder and neck pain may be caused by bursitis, a pinched nerve, whiplash, tendinitis, a herniated disc, or a rotator cuff injury. Symptoms also include weakness, numbness, coolness, color changes, swelling, and deformity. Treatment at home may incorporate resting, icing, and elevating the injury. A doctor may prescribe pain medications and immobilize the injury.
Kidney Pain Symptoms, Treatment, and Cure
Kidney pain has a variety of causes and symptoms. Infection, injury, trauma, bleeding disorders, kidney stones, and less common conditions may lead to kidney pain. Symptoms associated with kidney pain may include fever, vomiting, nausea, flank pain, and painful urination. Treatment of kidney pain depends on the cause of the pain.
Arthritis, bursitis, IT band syndrome, fracture, and strain are just some of the causes of hip pain. Associated symptoms and signs include swelling, tenderness, difficulty sleeping on the hip, and loss of range of motion of the hip. Treatment depends upon the cause of the hip pain but may include anti-inflammatory medications and icing and resting the hip joint.
Migraine vs. Headache: Differences and Similarities
Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine. Symptoms of migraine that usually aren't experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain. Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure. Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don't know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the "worst headache of your life," seek medical care immediately.
Treatment & Diagnosis
Medications & Supplements
- codeine (for Pain)
- hydrocodone/acetaminophen (Vicodin, Norco)
- clonidine (Catapres, Catapres-TTS)
- hydrocodone and ibuprofen, Vicoprofen
- hydrocodone (Zohydro ER)
- hydrocodone/homatropine (Tussigon)
- Oxycodone vs. Hydrocodone
- Dilaudid vs. Percocet for Pain
- Ketorolac vs. hydrocodone
- Ketorolac vs. tramadol
- Side Effects of Percocet (oxycodone/acetaminophen)
- Side Effects of Oxycontin (oxycodone)
- Side Effects of Norflex (orphenadrine)
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Centers for Disease Control. CDC Guideline for Prescribing Opioids for Chronic Pain. 29 August 2017. 9 November 2018
Eric Strain, MD. Opioid use disorder: Epidemiology, pharmacology, clinical manifestations, course, screening, assessment, and diagnosis. 13 September 2018. 9 November 2018
Kevin Sevarino, MD, PhD. Opioid withdrawal in adults: Clinical manifestations, course, assessment, and diagnosis. 10 April 2017. 9 November 2018
CDC Guideline for Prescribing Opioids for Chronic Pain. CDC. Updated: Aug 29, 2017.
FDA Prescribing Information
Eric Strain, MD. Opioid use disorder: Epidemiology, pharmacology, clinical manifestations, course, screening, assessment, and diagnosis. 13 September 2018.
Kevin Sevarino, MD, PhD. Opioid withdrawal in adults: Clinical manifestations, course, assessment, and diagnosis. Updated: April 2017.