If you are suffering from chronic pain, know that you aren’t alone—this issue affects the lives of millions of Americans every day. While it’s undeniable that receiving treatment can enhance the quality of your life, the truth is that not all pain management options are equally safe and effective. Taking opioids for chronic pain, in particular, can do more harm than good.
Read on to learn the key things you should keep in mind if you are taking or considering taking opioids for chronic pain, including the risks and dangers that come with long-term opioid use.
What Are Opioids for Chronic Pain?
Opioids for chronic pain refer to opioid pain medications prescribed to relieve pain that persists for longer than three months. Drugs belonging to the opioid family alleviate moderate-to-severe pain by interacting with the opioid receptors in the central nervous system (CNS).
Opioids, which can be administered orally, intravenously, transdermally, and in other ways, are classified into three major categories based on their origin:
- Natural opioids (opiates), such as morphine, which are extracted from poppy plants
- Semi-synthetic opioids, which are created in labs from opiates (oxycodone, hydrocodone, etc.)
- Synthetic opioids, which are fully human-made (e.g., fentanyl)
Moreover, many opioids come in two—immediate- and extended-release—formulations.
Immediate-release opioids have a rapid onset of action but are short-acting. Meanwhile, extended-release medications are long-acting but usually take longer to take effect, as they release their active ingredients into the system gradually, typically over 12–24 hours. Such opioids are used in cases that require around-the-clock pain relief.
Uses of Opioids for Chronic Pain
Using prescription opioids for chronic pain treatment is not recommended in most cases. Opioids should only be used to treat chronic pain when non-opioid treatment options aren’t available, and the benefits of taking them outweigh the risks.
Opioids have a significant potential for abuse, dependence, and addiction, which increases with long-term use. Moreover, the effectiveness of using opioids for long-term chronic pain management lacks sufficient evidence.
Though opioids may not be the best and safest option, they are sometimes prescribed to alleviate chronic pain associated with cancer and cancer treatment, as well as non-cancer chronic pain (e.g., neuropathic pain).
If you have to take opioids for chronic pain, it is recommended to start with immediate-release ones and take them at the lowest effective dose. Always follow your doctor’s directions to reduce the risk of abuse, dependence, and addiction.
Common Types of Opioids Prescribed for Chronic Pain
Here are some examples of common types of opioids prescribed for chronic pain and their brand names:
- Buprenorphine (Butrans®, Belbuca®)
- Tramadol (Ultram®, Ryzolt®, ConZip®)
- Hydrocodone (Norco®, Lorcet®, Vicodin®)
- Fentanyl (Duragesic®, Sublimaze®, Actiq®)
- Tapentadol (Palexia®, Nucynta®, Aspadol®)
- Oxycodone (Longtec®, OxyContin®, Oxypro®)
- Morphine (Kadian®, MS-Contin®, Morphabond®)
All opioids, regardless of the type, expose you to the risk of opioid abuse, increasing the risk of dependence, addiction, and overdose. In 2022 alone, 8.5 million Americans aged 12 and older misused these medications. Hydrocodone and oxycodone were the most commonly abused prescription opioids that year, with nearly 76% of people misusing these two drugs specifically.
Effects of Using Opioids Long-Term
Using opioids long-term can have a detrimental effect on your health, relationships, and quality of life. The longer you take opioids, the more likely you are to develop:
- Tolerance
- Opioid dependence
- Opioid addiction
- Urinary retention
- Fertility problems
- Chronic constipation
- Hormonal imbalances
- Respiratory depression
- Liver, kidney, and other organ damage
Moreover, long-term use of opioids for chronic pain can increase the likelihood of opioid-induced hyperalgesia. In other words, even though opioids are supposed to ease pain, taking them for a prolonged time can have the opposite effect and increase your sensitivity to pain. Prolonged use of opioids also makes you more vulnerable to an opioid overdose, which can be fatal.
How Is Tolerance to Opioids Developed?
Tolerance to opioids is developed due to the neurochemical changes that result from continuous opioid use over a prolonged time.
Simply put, repeated exposure to opioids causes your brain to reduce the production of endorphins, ”feel-good” chemicals also known as the body’s natural painkillers. As endorphin production decreases, your body begins to produce increasingly more active opioid receptors, which is what leads to tolerance.
Once the number of opioid receptors increases, you will no longer feel the drug’s effects without increasing the dosage. Unfortunately, this often prompts people to abuse opioids by taking them in larger doses, especially as cravings and other withdrawal symptoms kick in.
This is something you shouldn’t do under any circumstances, as it significantly increases the risk of addiction, overdose, and death. If you believe you might’ve developed opioid tolerance, discuss this with your doctor and refrain from taking more medication than prescribed.
Using Opioids for Treating Chronic Pain: Safety Concerns
Using opioids for chronic pain comes with substantial health risks and concerns. Because of this, it’s in your best interest to explore non-opioid treatment options before initiating opioid therapy. If opioids are your only option, take them strictly as prescribed at the lowest amount and for as little time as possible. This also applies to those taking them for acute pain.
Besides the risk of abuse, dependence, addiction, and overdose, opioids can also lead to various side effects, some of which may require medical attention and lead to lifelong complications.
The most common side effects of opioids include:
- Nausea
- Vomiting
- Sedation
- Itchy skin
- Dizziness
- Confusion
- Dry mouth
- Constipation
- Trouble breathing
- Sleep disturbances
Inform your doctor about any side effects you experience while taking opioids, including those not listed above. In case of an allergic reaction, seek immediate medical attention.
Dangers of Using Opioids for Chronic Pain
Given that persistent pain typically requires long-term treatment, using opioids for chronic pain can be even more dangerous than taking them for acute pain. Opioids gradually alter brain chemistry, even if you take them responsibly and closely follow your doctor’s instructions.
While the pain-relieving effects of opioids for chronic pain treatment lack evidence, it is no secret that many people taking these drugs experience euphoria and deep relaxation due to dopamine release. This further increases the risk of opioid abuse and addiction, with some people taking opioids just to feel “high” rather than to treat pain.
Doctors are aware of the dangers of prolonged opioid use, which is why they may refuse to renew the prescription. Sadly, it’s not uncommon for people to seek illicit drugs to help manage their cravings and other withdrawal symptoms once this happens, even though this puts them in harm’s way.
Some studies show that nearly 80% of heroin users have misused prescription opioids in the past.
Opioid Use Disorder
Opioid use disorder (OUD) is a treatable condition marked by the compulsive use of opioids that causes distress in your life. As per the Centers for Disease Control and Prevention, it is the preferred term for opioid addiction.
More often than not, people develop OUD after becoming physically dependent on opioids, which is why it is vital to seek professional treatment for opioid dependence.
Here are some signs and symptoms that may indicate that you or someone you love may be struggling with OUD:
- Being preoccupied with obtaining or using opioids
- Trying to quit opioids only to relapse, often several times
- Continuing to take opioids despite the negative consequences
- Failing to meet personal or professional obligations due to opioid use
- Taking opioids for non-medical purposes, in larger doses than prescribed, or abusing them in other ways
Moreover, people with OUD will often become isolated from their loved ones, hide, deny, or lie about their opioid use, and try to obtain opioids in illegal ways, such as by stealing and doctor shopping.
As devastating as living with OUD can be, it can be treated, regardless of how long you’ve been struggling with it.
Opioid Dependence vs. Opioid Addiction: What Are the Differences?
Opioid dependence and opioid addiction are two of the greatest risks of taking opioids. Though the words “dependence” and “addiction” are often used interchangeably, these are two different conditions, though they can co-occur.
Opioid dependence, which is characterized by tolerance and withdrawal symptoms, refers to the physical dependence on opioids people develop after taking them for a prolonged time. You can become dependent on opioids within as little as 4–8 weeks of regular opioid use, even if you take them precisely as prescribed.
Opioid-dependent people have to take increasingly larger doses of opioids to continue feeling their effects. They also rely on opioids to function normally, as not taking them induces opioid withdrawal symptoms, such as diarrhea, runny nose, and other flu-like symptoms, as well as cravings. Sadly, many people continue taking opioids just to avoid pain and discomfort.
If you don’t treat opioid dependence, it can eventually turn into addiction. Opioid addiction is mainly psychological, and it is characterized by the inability to control opioid use. People addicted to opioids continue to take these drugs despite the negative consequences, such as strained relationships, financial problems, and worsening work performance.
Can You Overdose on Opioids Prescribed for Chronic Pain?
You can overdose on opioids prescribed for chronic pain. This is a risk anyone taking prescription opioids faces, especially those who abuse them (i.e., take them in larger doses).
Due to the potency of opioids, even one extra dose can induce potentially life-threatening breathing problems and lead to an opioid overdose. For this reason, you should carefully track your opioid intake if you take opioids for chronic pain. People who relapse face a higher risk of overdose due to decreased tolerance, as do those who are opioid-naïve.
Opioid overdose happens when you take a larger amount of opioid medication than your body can safely metabolize.
Taking opioids for chronic pain can increase this risk, as those who take them for a prolonged time may be more likely to abuse them as a result of growing tolerance to the drug. Not to mention, opioids can sometimes build up in your system, increasing the risk of overdose.
If not treated promptly, opioid overdose can lead to brain injury, coma, and death.
For this reason, you should call 911 as soon as you recognize the following signs of an opioid overdose:
- Limp body
- Pinpoint pupils
- Unresponsiveness
- Extreme drowsiness
- Loss of consciousness
- Slow, shallow breathing
- Cold and clammy hands
- Discolored lips, skin, and nails
- Lightheadedness and confusion
- Snoring, choking, or gurgling sounds
ANR Treatment for Opioid Dependence
If you’re looking for a safe and effective way to overcome opioid dependence, Accelerated Neuro-Regulation (ANR) is your best option.
Developed by Dr. Andre Waismann, ANR is the first and only treatment that addresses the root cause of opioid dependence. As of today, it has helped close to 25,000 people worldwide return to a happy, healthy, and opioid-free life.
The ANR treatment is designed with your safety in mind; it is performed in an ICU setting of accredited hospitals by highly experienced board-certified healthcare professionals. We also tailor the treatment to each patient individually, which is why it can be safely performed even on those with complex medical conditions.
The therapeutic goal of the ANR treatment is to re-regulate the endorphin-receptor system to its normal state, reversing the damage opioids cause. By returning the brain to its pre-addiction state, ANR eradicates the root of opioid dependence, negating the risk of ongoing withdrawal symptoms and relapse.
The ANR procedure takes only 4–6 hours to complete. Better yet, the hospital stay for ANR patients lasts just 36 hours on average.
For more information, contact us to book a free, 100% confidential consultation!
Key Takeaways
The bottom line is that taking opioids for chronic pain is not safe or effective in the long run, which is why the CDC advises physicians against prescribing them in most cases.
If you are struggling with persistent pain, talk to your doctor to see which treatment best suits your unique situation and, if possible, avoid taking opioids altogether.
Lastly, let’s summarize the key points we covered today:
- Opioids are drugs that interact with opioid receptors to relieve moderate-to-severe pain, including chronic cancer and non-cancer pain. However, the evidence for their effectiveness in long-term pain treatment is limited.
- Taking opioids for chronic pain puts you at risk of opioid abuse, dependence, addiction, overdose, and death, among other adverse effects.
- If you must take opioids, do so for as little time as possible, as prolonged opioid use changes brain chemistry, leading to opioid dependence.
Opioids for Chronic Pain FAQ
Some of the most commonly prescribed opioids for treating chronic pain include hydrocodone, tramadol, buprenorphine, morphine, and oxycodone. However, there’s a lack of evidence for the effectiveness of opioids for chronic pain treatment.
Opioids, in general, are not recommended for treating long-term pain. This is because, in most cases, the risks of taking opioids for chronic pain outweigh the benefits. Since long-term use of these drugs can—and does—lead to dependence and addiction, you should only take opioids for chronic pain if no other treatment alternatives are available.
If your chronic pain is unbearable, seek medical attention immediately. Do not take any medications that have been prescribed to someone else, as it could cause dangerous side effects and lead to an overdose.
If you have been using opioids for a long time, you can taper off them under your doctor’s supervision to reduce the severity of withdrawal symptoms.
Do not attempt to quit them suddenly or without medical supervision, as this increases the risk of severe withdrawal symptoms, relapse, and overdose. The ANR treatment can help you avoid withdrawal symptoms altogether and overcome opioid dependence in a matter of days.
Using opioids for chronic pain is not recommended to most people, including those with a history of substance abuse. Anyone who takes opioids for a prolonged time faces the risk of opioid abuse, dependence, and addiction.
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