The Basics of Opioids
Questions about the long-term benefits of opioid pain medications are increasing. It’s important that patients understand the basics before beginning treatment, because while opioids provide effective pain relief in the short term, the risk of side effects and long-term impacts like addiction must be taken into account.
How Opioids Work
Opioids provide pain relief by mimicking pain-relieving chemicals that are produced by our bodies naturally. In order for pain signals to reach your brain (and for you to feel pain), the signal must travel through a receptor. Opioid drugs bind to these receptors in your brain and other parts of the body to block your perception of pain. Thus, the cause of the pain does not go away, but you may feel less pain. A common misconception of patients is that opioids will make them pain free.
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While pills are the most common way patients take opioids, they can also be prescribed in the following formulations:
Injection into a muscle
Intravenously through a vein
Patch applied to skin
Suppository placed into the rectum
Spray or patch under the tongue
Pill or capsule that dissolves in the mouth
Different Types of Opioids
The goal of all opioids is pain relief, but they can have different characteristics, such as being short- or long-acting.
Short-acting or immediate-release opioids begin working immediately and will provide peak pain relief in 1 to 2 hours with effects lasting up to 4 hours.
Long-acting or extended-release opioids are released into the body slowly over many hours and the effects may last 12 or 24 hours (some are designed to last days). These formulations provide steady relief over time.
Your doctor will look at your situation and prescribe the regimen that best meets your need. He or she may also prescribe a non-opioid drug in combination with your opioid treatment, or combine a long- and short-acting opioid to meet your pain needs.
In 2014, there were nearly 1.5 times more opioid-related deaths than motor vehicle deaths in the United States. Even when taken as prescribed, people can become addicted to opioids. However, the risks significantly increase when opioids are not taken as directed or are taken in combination with other substances such as alcohol or other drugs with abuse potential.
Everyone has a different risk of addiction and some people are at greater risk than others. If you have a personal or family history of alcoholism or drug abuse, you may have a higher risk of getting addicted to opioids. If you’re concerned about developing an addiction to your opioid medication, talk to your doctor about the best way forward.
When we talk about opioid addiction, it’s important to understand the concepts of opioid tolerance and opioid dependence. Tolerance occurs when chronic users require higher and higher doses over time to achieve the same level of pain relief. While tolerance is not considered addiction, higher doses of opioids are associated with an increased risk of side effects.
Many chronic opioid users develop what we call dependence. That means they experience withdrawal or other negative symptoms if the drug is suddenly stopped. Dependence is a physiological change, rather than the compulsive behavior that defines addiction.
Side Effects of Opioids
All drugs have side effects and opioids are no different. People commonly experience the following when taking opioids:
THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
Dr. Pat Bass is chief medical information officer and an associate professor of medicine and pediatrics at LSU Health- Shreveport and University Hospital. View his Healthgrades profile >