Chronic Pain Narcotics - The Risks of Narcotics Should Not Be Ignored

Written by David Greene, MD

Narcotics are often prescribed in the US for treating acute and chronic pain issues like reflex sympathetic dystrophy, degenerative arthritis flare-ups, and for post-operative pain control.

Narcotics may be very effective, but they are not without risks. One of the most concerning risks is that of overdose, which may be fatal.

It is very important not to take more than the prescribed dose, and also not to mix various sedating narcotics together or with other substances that may potentiate this effect. This may include alcoholic beverages or benzodiazepines like Valium.

Although overdoses are regularly seen in the public eye such as when a celebrity dies from one, they occur way too often. Sometimes patients overdose on narcotics on purpose, but typically it's just not being cognizant of the various cumulative effects.

If a patient has severe pain, he or she may just simply take more and more out of desperation, with an unintended fatal result.

Less than fatal side effects are common and may include light headedness, dizziness, drowsiness, or vomiting and nausea. Dry mouth is very common, which if experienced over a long period may contribute to tooth decay.

Along with this, one can see loss of appetite, nervousness, restlessness, headaches, blurred vision, and constipation.

One major risk of pain medications is tolerance. This is when individuals need a larger amount of narcotics to feel the equivalent effect of pain relief.

This can end up in a vicious cycle of narcotics spiraling where the person needs a lot more than what their pain condition should actually need.

Additional complications can involve clammy cold skin, extremely small pupils, bluish skin discoloration, extreme sleepiness, severe drowsiness, unresponsiveness, and slow heartbeat or low blood pressure.

Along with these risks, people taking these meds should let their provider know before taking narcotics:

Central nervous system (CNS) depressants, like antihistamines.

Monoamine oxidase (MAO) inhibitors, like phenelzine (Nardil) and tranylcypromine (Parnate).

Tricyclic antidepressants, such as amitriptyline (Elavil).

Anti-seizure medicines, like carbamazepine (Tegretol).

Muscle relaxants, such as cyclobenzaprine (Flexeril)

Sleeping pills, including triazolam (Halcion)

Blood-thinning drugs, including warfarin (Coumadin)

Naltrexone (Trexan, Revia). Cancels the effects of opioid analgesics.

Rifampin (Rifadin)

There are quite a few narcotics that come with acetaminophen in the mix, which can be harmful to the liver if too much is taken. So care should be taken not to take over 4 grams per day total.

Again, severe care should be observed with narcotics and patients should make sure to be under the care of a physician during use and only intake according to the dose that is prescribed.

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