Opioids

About

Opioids are medications that produce strong pain relief by acting on receptors within the body that alter the signalling of pain.

Opioids are either weak or strong opioids. Examples of weak opioids are tramadol (Tramal) and codeine. Codeine is contained in many “over the counter” as well as prescription medications including Panadeine, Panadeine Forte, Nurofen Plus and Mersyndol Forte. Strong opioids include morphine (eg MS Contin, Kapanol, Sevredol), oxycodone (Endone, Oxycontin, Targin), fentanyl (Durogesic), buprenorphine (Norspan), pethidine, hydromorphone (Dilaudid, Jurnista), tapentadol (Palexia) and methadone (Physeptone).

Opioids come in short acting and long acting (sustained release) formulations. They come in tablet, liquid and patch form.

Be Aware

There are significant risks from opioid medications that must be considered before commencing treatment.

Common side effects include constipation, nausea, vomiting and sedation. Serious risks include respiratory depression (impaired breathing) and risk of death due to overdose.

Long term use of opioids can result in tolerance to the medication (the medication stops being as effective after time so the dose needs to be increased), dependence and addiction. When opioid medications are stopped the patient can experience withdrawal symptoms.

It is generally accepted that opioids should not be used for osteoarthritis except in patients who have moderate to severe pain who have tried all other treatment options. In these circumstances it may be acceptable to use opioids in the short term on an intermittent basis. Continuous use of opioids should be avoided unless patients have severe pain, have tried all other treatment options and are not suitable for surgery.

Opioid therapy should always be started as a trial, with the understanding that the medication will be stopped if it does not work or if adverse effects occur.