Prescription Pain Killers

What are narcotics?   
Narcotics are prescription pain killers dispensed for pain from accidents, surgical wounds, or illness.

Some familiar narcotics dispensed by doctors and dentists for extreme pain are:

Codeine
Morphine
Opium
Methadone
Meperidine (Demerol®)

     In addition to being used for pain relief, narcotics are also employed in conjunction with anesthesia to enhance its effects.
[Note: Following surgery, instead of a pain pill, local anesthetic can be administered to control pain.]  
     Certain ones (namely codeine and hydrocodone) may be used to stop coughing.

Other narcotics are:

Hydro- and Oxy- codone
Anileridine
Buprenorphine
Butorphanol
Hydro- and Oxy- morphone
Levorphanol
Pentazocine
Propoxyphene
Nalbuphine

How do narcotics stop pain?  
     Narcotics are central nervous system depressants that block nerve transmission.

How often can morphine be taken?  
     Narcotics are generally taken every three to six hours, as needed (for morphine doses are usually taken four hours apart-or every twelve hours apart for the extended release form).

[Warning:  If one feels that a narcotic is not sufficiently taking care of the pain, do not take more of it than was prescribed or take it more often.  Rather, inform the doctor of the situation.  If a dose is forgotten about and it is nearly time to take the next dose, skip the missed dose entirely. Overdose can occur if dosages are exceeded.]

On the other hand, a patient should not suddenly stop taking the medication, because stopping abruptly is tends to result in more severe withdrawal symptoms.  These symptoms are especially likely if the medicine has been taken for a prolonged period of time (i.e. for several weeks or longer).  Under these circumstances it would be advisable to taper off gradually.
Are narcotics dangerous?  
Narcotics are mentally as well as physically addictive. 

Patients become habituated to the drug, which means that it takes higher and higher doses of the medication to stop the pain. 
Unfortunately when the person quits taking them, s/he will suffer uncomfortable withdrawal effects. 
The doctor will periodically perform check-ups on anyone who must take narcotics for months at a time.
     In addition to tolerance and addiction, side-effects of narcotics are:

Physical Changes:

Vomiting or Nausea (particularly initially)
Loss of Appetite
Constipation (most frequently with codeine or long-term use of other narcotics such as morphine)
Headache
Blurred or Double Vision
Dry Mouth
Weakness (mild)
Withdrawal Symptoms
Mental Changes:

Dizziness or lightheadedness (mild)
Drowsiness (mild)
Nervousness or Restlessness (mild)
Nightmares
Withdrawal Symptoms

[Note: For feeling faint or nauseous, lying down should help.]

Aggravation of Certain Health Conditions
[Warning: In the case of more-pronounced drowsiness, dizziness, weakness, or restlessness, these symptoms may be warning signs of overdose. Narcotic overdose can be fatal.]

     Are there any more signs of overdose that you can tell apart from the regular expected side-effects?  
More-distinct symptoms of overdose from narcotics are:

Cold, Clammy Skin
Tiny Pupils
Labored Breathing
Decreased Pulse
Low Blood Pressure
Convulsions
Increased Sweating
Blisters
Confusion
Delirium
Deep Sleep or Loss of Consciousness
     All patients taking narcotics should realize that combining them with another central nervous system depressant increases the risk for overdose. Therefore, they should check with their doctor or pharmacist before drinking alcohol or taking any of the following:

Antihistamines
Cold Medicines
Allergy Medicines
Tricyclic Antidepressants
Muscle Relaxants
Sleeping Pills
Tranquilizers
Anticonvulsants
Anesthetics
     Infants (under two) and the elderly are particularly sensitive to narcotics, thus susceptible to complications, especially trouble breathing. 

Never leave narcotics where a child may come across them, which includes accessible wastebaskets.  (Regardless of whether or not there is a young child in the home, the drug should not be stored in bathroom cabinets, since humidity breaks it down.)
Warning: Do not take more than the allotted number of doses.  (For skin patches, take care that more than one patch is not applied simultaneously, as can happen accidentally when there is more than once caregiver.)  
Do not use with any form of heat with a patch (not only heating pads, but also heated water beds or hot baths).
The use of heat increases the amount of the drug that is absorbed, which can result in overdose.

     What sorts of withdrawal symptoms do narcotics cause? 
     Along with the urge to keep taking the drug, when stopping, narcotics users experience:

Trouble Sleeping (which may continue for several nights)
Fast Heart Beat
Dilated Pupils
Nervousness, Restlessness or Irritability
Cramps, Nausea, or Vomiting
Increased Sweating
Cold Symptoms:
Fever
Runny Nose
Aching
Shivering 

Which illnesses do narcotics make worse? 
     Health conditions that are exacerbated by narcotics include:

Asthma
Emphysema
Hypothyroidism
Gallbladder Disease
Cardiovascular Disease
Ulcerative Colitis
Benign Prostate Hyperplasia
Liver Disease
Kidney Disease
Head Injury
Epilepsy
Brain Tumor

     Are narcotics safe to take when I'm pregnant or breastfeeding?  
     There are concerns about the effects of narcotics on a developing fetus.  Research has not been done in humans, but some of the drugs (morphine, hydrocodone, and hydromorphone, but not codeine) have caused birth defects in animals (when given in quite large amounts).

Although they have not been implicated in causing birth defects in humans, narcotics do make the fetus become drug dependent. 
(In addition, they may cause labored breathing in newborns when taken for labor pain.) 
Due to concerns about birth defects, it may be safer for a woman to be off narcotics while she is expecting.
Narcotics do pass into the breast milk.  However, they have not been reported to cause problems in nursing infants.

     Are narcotics only given by doctors in the hospital? 
     Prescriptions for narcotics are dispensed, however, due to their addictive effects narcotics often cannot be refilled without a new prescription.  Narcotics can be given:

Orally, in:
Pill Form
Tablets,
Fast-Acting Capsules, or
Extended-Release Capsules
Liquid Form
Suspensions or
Syrups
As a Transdermal Patch
By Injection, or directly into the bloodstream through an IV Line.
Rectally, as a suppository

Source: U.S. National Library of Medicine

The material in this article is provided for informational purposes only. For specific medical advice or diagnosis, consult a healthcare provider.