Opioid info

Question 1

What are opioids?

Answer 1

Naturally occurring or synthetic chemicals resembling morphine in pharmacological effects 
•	Oxycodone*  
•	Morphine* 
•	Hydrocodone Methadone
•	Hydromorphone*
•	Meperidine (or pethidine)
•	Fentanyl* 
•	Codeine
              * Most commonly prescribed

Question 2

Opioids are commonly used for:

Answer 2

• Time-limited pain management of medical procedures, dental procedures and acute injury and disease
• Open-ended palliative care of patients with late-stage or end-stage disease
• Short- or long-term (2 months, nearly daily) chronic pain management
Limited research for opioids for long-term management of chronic pain

Question 3

Expected pain relief:

Answer 3

• Short-term randomized trial of opioids for chronic pain have found modest analgesic benefits
  o 1/3 reduction in pain intensity on average

Question 4

Common side effects with chronic opioid use

Answer 4

• Constipation, nausea, sleep problems (e.g., apnea), reduced sexual function, loss of muscle strength/ mass, increased risk of osteoporosis

Question 5

Possible adverse effects with opioids

Answer 5

• Anaphylactic or allergic reactions (e.g., hives, bronchospasm) to opioids are rare
• Hives or itching
• Constipation
• Nausea and vomiting
• Sedation (“mentally clouded”)
• Delirium
• Respiratory depression

Question 6

Opioid prescriptions and increasing adverse effects

Answer 6

• 30% of adults in the US experience chronic pain
• Opioid prescriptions in the US
• From 1997 to 2002, morphine use increased by 74%, hydromorphone by 96%, fentanyl by 226%, and oxycodone by 403% in the US.
• From 2007 to 2012, opioid prescriptions increased by 7.3%
• Rates of overdose, death, and addiction tx
• Fatal overdoses involving opioid analgesics increased 4x from 1999 to 2010 in the US (16,000 per year)
• Studies have found prescription-opioid addiction among 4 - 26% of chronic opioid therapy patients

Question 7

Some alt. to opioids

Answer 7

• Substitution medications
• buprenorphine
• methadone
• naltrexone
• Examples of “Pain Modifying’ medications
• venlafaxine, duloxetine, gabapentin, pregabalin, anti-convulsants, carbemazapine, topiramate, tricyclics, clonidine, cannabinoids