Narcotics for Back Pain

Narcotics are very powerful drugs that are not legally available without prescription. They work by attaching themselves to the pain receptors in the central nervous system blocking pain messages from being received and also by altering the sensation and perception of pain.

There are two types of narcotics; opiates and opioids. Opiates are natural or semi-synthetic products that are derived from the poppy seed, and well known types are morphine and codeine. Opioids can also be totally synthetic, and include methadone and pethidine and many agents given with a general anaesthetic.

Narcotic agents are very good for combating severe acute pain, palliative pain, post-operative pain and more recently have been indicated for the treatment of otherwise uncontrollable chronic pain conditions. They will probably be prescribed alongside a non-steroidal anti-inflammatory drug, as they do not have any anti-inflammatory qualities.

Their use is acceptable in conditions such as sudden disc herniation or trauma from an accident or fall, but is not valuable in the treatment of long-term conditions such as arthritis.

Their use for periods over 2 weeks is not recommended. They are intended to help sufferers get over the onset of severe pain and other treatments should be sought after this time.

Methods of Administration

Narcotic drugs can be given by several routes including orally, by injection, intra-venously (directly into the blood stream via a vein) or through an adhesive skin patch. The effect of the drug can vary due to the route of administration, the dose of the medication, the patient’s expectations and perceptions of these drugs and the patient’s emotional well-being prior to receiving the drug.

Side-Effects

There are many side effects associated with the use of these drugs and your physician may well prescribe additional medications, such as laxatives or anti-histamines to combat these effects. Common consequences include nausea, itching, constipation, depression, a change in mood or more seriously respiratory depression. In the event of respiratory difficulty, medical help should be sought immediately as this can be a potentially life-threatening occurrence.

It is important to exercise caution with driving and the use of machinery or equipment when taking any narcotic drugs.

Dependence and Tolerance

They are addictive substances and tolerance and dependence can build-up over prolonged use, resulting in the need for higher doses at shorter intervals.

Given in low doses they are good for pain, but higher doses increase the chance of euphoric feelings and altered mental state, hence their popularity as a recreational drug.

Withdrawal

If there has been long-term use of these agents and the medication is stopped all of a sudden, the person may experience symptoms of withdrawal. Typical responses are diarrhoea, cravings for the drug, restlessness, insomnia, depression and cold sweats. These symptoms can start within hours of stopping the drug and can last for up to three full days.

Narcotic drugs are to be prescribed with caution, and every patient will react differently to them. Thorough discussion between patient and physician should take place before prescription to ensure a treatment plan for pain relief is suitable for each individual.

Physicians and patients should aim to find a balance between acceptable pain relief and acceptable side-effects.