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Opioids are medicines used to treat severe or long-term chronic pain. Some are stronger than others. The most common side-effects are constipation, feeling sick and tiredness. Other possible problems with opioids include dependence and addiction. When prescribed responsibly in line with good practice guidelines, addiction does not usually occur. Opioids sometimes called opiates are medicines used to treat pain.
There are many different types of painkillers that are suitable for different types of pain. Most doctors will start off prescribing a lesser strength painkiller such as paracetamol or ibuprofen. If these do not work, depending on the type of pain you have, your doctor may consider prescribing an opioid.
Opioids work by attaching to receptors in the brain and spinal cord, the gut and other parts of the body. This le to a decrease in the way you feel pain, changes your reaction to pain, and increases your tolerance for pain. Even though List of narcotic painkillers by strength strong opioids are classified together, they can also differ a lot in strength.
The stronger List of narcotic painkillers by strength may be ten times stronger than the weakest. Strong opioids are usually prescribed for more severe types of pain - for example, if you have had an operation or have been injured in a car accident. They may also be considered for people who have long-term pain, when other painkillers have not worked.
They are also often used for pain in people with cancer. The weaker opioids are usually taken as tablets. There are dispersible and liquid forms. They may come in brands which combine paracetamol and the opioid. Strong opioids can be taken as:. They all come in various different brand names and not all brands are the same. Once you have started taking one brand you should stick to the same one, unless your doctor has told you to switch to another. Although there are quite a few strong opioids, the most commonly prescribed one is morphine. If your doctor thinks that a strong opioid would help your type of pain then morphine is often the first strong opioid to be prescribed.
If this does not work, your doctor may consider switching you to a different List of narcotic painkillers by strength. Each different opioid medicine will have different instructions. Your doctor and pharmacist will explain exactly when and how to take them.
The principles of taking morphine are important and it is a good idea to understand how and why your morphine is prescribed in a certain way. To start off with, you will usually be given a quick-acting strong opioid morphine tablets or liquid as well as a slow-release morphine tablet or capsule. The slow-release preparation is usually taken once or twice a day, depending on which brand you have been given. Slow-release preparations give a steady level of medicine in the body throughout the day. However, sometimes you can experience pain before you have your next dose of slow-release morphine; this is called 'breakthrough' pain.
Quick-acting morphine is used to ease breakthrough pain. It can be taken every four hours, when you need to. Your doctor will start you off on a low dose of slow-release morphine and increase this over a of weeks until your symptoms have eased. It is a good idea to write down how much quick-acting morphine you are using each day. Your doctor can then use this information to increase the dose of your slow-release morphine in order to keep you pain-free.
As with all medicines, opioids have a of possible side-effects. In general, the stronger the opioid, the more likely you are to have side-effects. The most common side-effects are constipation, feeling sick nausea and drowsiness. A dry mouth can also be a problem.
Some people find drinking plenty of liquids or chewing gum may help with this. It is important to tell your doctor straightaway if you think you have any of these side-effects. The dose of your opioid may need to be decreased. If you have been wearing a prescribed fentanyl patch, remove it from the skin straightaway and speak with your doctor if you develop any:.
Addiction and dependence are also possible problems caused by opioids.
These are discussed in the section below. The above is not a comprehensive list - just the main possible side-effects to look out for. For a full list of possible side-effects, see the leaflet that comes with your medicine. Opioids have a serious risk of addiction, especially with long-term use. They highlight the importance of patients and doctors having full discussions about:. Opioids, when taken for List of narcotic painkillers by strength long time, can cause tolerance, dependence and addiction. These are all different.
Not everyone who takes opioids develops these problems. Dependence and tolerance occur more commonly than addiction. Tolerance : if you have been taking opioids for a long time, they do not work as well as they did in the beginning. You may need a higher dose to treat your pain. This is called tolerance. Dependence : if you gradually become more tolerant of the opioid, you may become dependent on it. This is NOT the same as addiction.
It means that if you miss a dose, or stop the opioid suddenly, you may have withdrawal symptoms. You may need to keep taking the medicine to avoid the withdrawal symptoms. Dependence is treated by a planned gradual reduction in the opioid medicine.
The dose is gradually reduced in such a way that your body can become used to it, so that you do List of narcotic painkillers by strength experience withdrawal symptoms. This does not mean you are addicted to the opioid. Withdrawal symptoms : these occur if you have developed a physical dependence to opioids as above and then stop taking them suddenly. Withdrawal symptoms include:.
Addiction : this is an excessive craving for the opioids. There is uncontrollable and compulsive use of the medicine. People who are addicted still have cravings for the opioids even after they have reduced them slowly so that they are no longer dependent.
Some people are more likely to develop addiction than others and seem to be particularly sensitive to the cravings. It is unusual for people who are prescribed opioids for pain to become addicted to opioids. This depends on the cause of the pain and the reason for treatment. Opioids may be taken for as long as they are helping to ease your pain. Some people take these medicines for many years.
It is important to reduce the opioids if they are no longer needed. Do not suddenly stop taking opioids. This is because you may develop withdrawal symptoms discussed above if you stop them suddenly. If you want to stop taking these medicines, you should discuss this with your doctor and bring the dose down slowly. Many people find that after some time they can reduce their dose without their pain increasing. Your doctor will advise you. You should not drive if are drowsy or confused because of our medication. You are more likely to feel drowsy at the start of treatment and when you have a dose increase.
So it is sensible not to drive if you have just started taking an opioid, or if the dose has been increased. Once you are settled on the dose, if you do not have any side-effects which might affect your ability to drive, you may return to driving.
It is your responsibility to judge whether you are fit to drive. It's illegal to drive if you're unfit to do so because of prescribed drugs. The police can stop you and make you do a 'field impairment assessment' if they think you're on drugs.
This is List of narcotic painkillers by strength series of tests - eg, asking you to walk in a straight line. If they think you're unfit to drive because of taking drugs, you'll be arrested and will have to take a blood or urine test at a police station. Some weak opioids are available to buy over the counter at a pharmacy. This is mainly in the form of a low dose of codeine in combination with paracetamol.
The dose is lower than the dose usually prescribed by doctors. You cannot buy strong opioids. These medicines are only available on prescription, from a pharmacy. These medicines are also referred to as 'controlled drugs'. This means that they have to be stored in a special cupboard in the pharmacy and that doctors have to write these prescriptions in a certain way. If you need to travel abroad with a strong opioid, you will need to check first with the embassy or high commission of the country you are visiting to see if they will allow you to take these medicines with you.
If these medicines are allowed, you will then need a letter from your doctor which states the following:. For people who are travelling for more than three months, a licence from the Home Office is required. Your doctor needs to fill in this form and send it to the Home Office. To obtain a licence you can:. Note : it can take up to two weeks for this form to be processed by the Home Office.
It is best to allow plenty of time to apply for this licence. It is very rare for anyone not to be able to take some type of opioid. The main reason why you may not be able to take an opioid is if you have had a List of narcotic painkillers by strength side-effect or an allergic reaction to a particular type of opioid in the past. Even if this happens, your doctor will usually be able to choose a different type of opioid, which you will be able to take.
In some groups of people, doctors only prescribe opioids very cautiously and at a lower dose. For example, this might apply if you:. If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at www. The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines or any other healthcare products may have caused. If you wish to report a side-effect, you will need to provide basic information about:.
UK, September Stannard C ; Opioids in the UK: what's the problem? Hi, I'm looking for advice if anyone can help. For around 7 months I've been having pain not sharp, more like a dull ache which is quite uncomfortable in my sides. It started in my right side under Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy.
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26 Commonly Used Opioid Medications