Chronic Pain (cont.)
IN THIS ARTICLE
Complications of Opioids
Nausea and vomiting: These are common side effects at the beginning of opioid therapy. If they are a problem, they can be controlled with nonprescription medication for nausea such as meclizine (Bonine, Dramamine), or diphenhydramine (Benadryl), or, in some cases, by prescription medication such as prochlorperazine (Compazine) or haloperidol (Haldol). The nausea and vomiting usually stop within a few days, and then the antiemetic (antinausea and vomiting) medication can be stopped.
Dizziness: Dizziness and sleepiness are common when you take opioids. That is why it is recommended that patients not drive, drink alcohol, or operate machinery while taking opioids. People who have chronic pain often develop tolerance for this side effect of opioids, and often can do all the normal activities of daily living while on opioid therapy.
Constipation: Opioids always cause this problem, and constipation continues to be a problem for as long as the patient takes opioids. Constipation can become a serious problem if the patient does not keep it under control. The stool can become totally blocked off (fecal impaction) to the point at which manual disimpaction must be performed. Stool softening medications such as docusate can help prevent or relieve constipation.
Addiction: Hospice patients worry about becoming addicted to opioids. With hospice, however, it is rarely an issue. People with chronic pain also worry about addiction, but it turns out that for most adults, if they do not already have a substance (alcohol or drug) abuse problem, addiction is not much of an issue even when opioids are used on a long-term basis.
Respiratory depression: The most dangerous complication of opioid therapy is respiratory depression. A lot of people know that some drug addicts have been known to get pure heroin or fentanyl, and then die with the needle still in their arm because they fell asleep and didn't breathe. That happens because of a huge overdose in a patient who is not in pain. Pain is a potent stimulator of the respiratory center in the brain. So if a person has pain, and the doctor increases the dose of opioids carefully until the pain is controlled, and then stops raising the dosage, the patient will not get respiratory depression.
Fortunately for people with pain, large doses of opioids can safely be used if they are necessary to combat severe chronic pain.
Medically Reviewed by a Doctor on 6/19/2014
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