What are opioids?
Opioids are the most commonly prescribed class of medication in the United States and are most often used for the short-term relief of chronic pain. Opioids are a broad class of medications that act on specific opiate receptors to induce opium or morphine-like effects, which therapeutically produce analgesia (pain relief).
Common opioid medications include morphine, codeine, oxycodone, oxycontin, hydrocodone, methadone, and fentanyl. Analgesic effect is the same among different opioids; however, the potency and side effects of the various drugs can differ.
Who is a good candidate for opioids?
Opioids are generally prescribed to patients with moderate or severe pain that negatively impacts their quality of life, persists for several weeks, and/or is unresponsive to other pain relievers, such as acetaminophen or ibuprofen.
How opioids work
Opioids attach to receptors in the brain. Once attached, they send signals to the brain to induce the "opioid effect" which blocks pain, slows breathing, and has a general calming effect. This leads to the short-term relief of various forms of pain.
Are there risks?
Like many medications, opioids can have unpleasant side effects such as drowsiness, nausea, vomiting, cramping, constipation, itching, breathing difficulty, or hallucinations. Many of these side effects disappear with time or can be managed with dosage adjustments and additional medications as necessary.
In addition to the risks above, there is also a potential for opioid misuse, due to the euphoric effects. Because of this, many physicians restrict or closely monitor their prescription of opioid medications, particularly for patients with a history of alcohol or other drug-related abuse. Additionally, high dosages or opioid misuse often result in overdose, which can cause life-threatening depression of respiration and the central nervous system.
If opioid therapy is indicated, the physician will assess the potential risks and benefits of treatment, including the risk of future abuse and dependence. A history of alcohol or drug abuse for the patient or close family is the strongest predictive factor for opioid misuse and may necessitate evaluation by a substance abuse specialist or psychologist. Despite these risks, opioid therapy can be used safely and effectively in properly screened patients.