Opioid Side Effects: Short-term and Long-term Impact on the Body

Constipation is a common complaint, but the effects are wide-ranging and can be severe.

Similar to any medication, whether prescribed or not, opioids are associated with a range of potential side effects. What sets opioids apart from many other commonly used medications is their propensity to induce strong addiction. This distinctive characteristic underscores the possibility of misuse or, in severe cases, overdose, as highlighted by the Substance Abuse and Mental Health Services Administration.

Nonetheless, if a medical professional deems it appropriate to prescribe a short-term opioid regimen to alleviate your pain, it becomes essential to make a well-considered decision regarding the necessity and duration of such treatment. Being well-informed about the potential side effects of opioids empowers you to assess the advantages and disadvantages judiciously.

What Types of Opioids Can Cause Side Effects?

To grasp the intricacies of opioid side effects, it’s crucial to acquire a brief overview of these substances. Specific opioids are medically prescribed to address pain ranging from moderate to severe. In contrast, there are illicitly manufactured opioids that circulate unlawfully, often sought after for the euphoric sensations they can induce.

Prescription opioids

Categorically, opioids can be segmented into distinct subtypes, each possessing unique characteristics and applications. One subset comprises natural opioids, such as morphine and codeine, originating from natural sources like the opium poppy. These compounds have long been harnessed for their analgesic properties, aiding in the management of pain across various medical contexts.

In parallel, the realm of semi-synthetic opioids emerges, constituting a bridge between natural and fully synthetic compounds. Within this subset, substances like oxycodone, hydrocodone, and oxymorphone are crafted by chemically modifying natural opioids. This deliberate alteration enhances their potency and pharmacological profile, thereby tailoring their efficacy for specific pain management scenarios.

However, the opioid classification extends beyond nature-inspired derivatives to encompass fully synthetic opioids, where fentanyl assumes a prominent role. Fentanyl stands out as a powerful synthetic opioid, meticulously designed to target specific receptors in the brain and spinal cord responsible for pain perception. Available under distinctive brand names such as Actiq, Duragesic, and Sublimaze, fentanyl has found application in diverse medical interventions, including surgical procedures and severe pain management.

In essence, the opioid spectrum is characterized by this triad of natural, semi-synthetic, and fully synthetic compounds, each carving its niche in the realm of pain management and medical treatment, while simultaneously demanding careful consideration of their potential risks and benefits.

Illegal opioids

This category encompasses substances such as heroin, derived from morphine, capable of being consumed through smoking, sniffing, injection, or snorting. Heroin swiftly engages with opioid receptors responsible for functions like pain perception, pleasure, heart rate, and respiration, as stated by the National Institute on Drug Abuse (NIDA).

Illicitly produced fentanyl, available as a powder, nasal spray, or pill, shares physiological effects with other opioid analgesics, yet it notably carries an elevated danger of overdose, as cautioned by the US Drug Enforcement Agency.

Beyond generating a sense of euphoria, opioids entail more profound implications. Foremost, the looming threat of overdose persists. In 2019, approximately 50,000 Americans lost their lives due to drug overdoses linked to opioids, as reported by the Centers for Disease Control and Prevention (CDC) Injury Center.

Additionally, the spectrum of opioid side effects is extensive.

Side Effects of Short-term Use

The effects stemming from opioid usage exhibit significant variation based on individual factors, duration of use, and quantity consumed. Yet, there are several overarching opioid-related effects that merit awareness.

According to Ashley McGee, RN, Vice President of Nursing at Mountainside—a comprehensive provider of drug addiction treatment serving New York, New Jersey, and Connecticut—the immediate effects of opioid use encompass:

1. Nausea

2. Decreased respiratory rate

3. Unconsciousness

4. Elevated drowsiness

5. Constricted pupils

6. Constipation

In certain scenarios, these effects necessitate supplementary treatment strategies. As highlighted by Harvard Health Publishing, constipation arises in 41% of individuals using opioids for noncancerous chronic pain and a staggering 94% of those using them for cancer-related pain. Consequently, medical professionals often consider the prescription or recommendation of laxatives concurrent with opioid usage initiation. Angela L. Robinson, LPCMH, NCC, Clinical Director at NorthNode Group Counseling in Dover, Delaware, elucidates that some patients cease opioid consumption due to the profound pain and discomfort caused by constipation.

For more potent opioids like fentanyl and heroin, the potential side effects can be notably more severe. According to the National Institute on Drug Abuse:

Fentanyl’s effects encompass:

1. Drowsiness

2. Nausea

3. Constipation

4. Confusion

5. Breathing difficulties

Meanwhile, heroin’s immediate effects include:

1. Fluctuating states of consciousness

2. Dry mouth

3. Skin flushing

4. Heaviness in limbs

5. Nausea

6. Vomiting

7. Intense itching

Side Effects of Long-term Use

Extended opioid utilization can give rise to a broader array of side effects. According to the National Institute on Drug Abuse (NIDA), prolonged heroin consumption can engender an extensive range of consequences, including:

1. Insomnia

2. Collapsed veins

3. Impaired nasal tissue

4. Constipation

5. Abdominal cramping

6. Liver and kidney ailments

7. Pneumonia

8. Depression

9. Sexual dysfunction

10. Irregular menstrual cycles

11. Withdrawal symptoms

Illustrating the behavioral transformation induced by prolonged opioid usage, Angela L. Robinson, LPCMH, NCC, elaborates that, beyond gastrointestinal issues and lethargy, the protracted effects alter an individual’s mental focus towards an obsessive preoccupation with opioids and their next dose. This shift in perception modifies the perception of pain, heightening sensitivity due to both pain suppression and the diminished natural tolerance threshold.

Further insight is provided by Damioli, who underscores the imperative for long-term opioid users to integrate non-opioid-centric approaches for pain management. Failing to do so can exacerbate the heightened sensitivity to pain experienced over time. Damioli also emphasizes that constipation may persist and intensify during prolonged opioid use.

It is critical for individuals embarking on extended opioid regimens to be well-informed about the potential comprehensive impact on their well-being and to consider diversified strategies for pain management to mitigate adverse effects.

Opioid Withdrawal

Owing to their highly addictive properties, the onset of opioid withdrawal can occur with remarkable swiftness. Notably, the Mayo Clinic underscores that even a mere five days of opioid usage can significantly elevate the chances of developing dependence on opioids.8

As detailed by the US National Library of Medicine, the aftermath of opioid withdrawal encompasses a spectrum of effects:9

1. Agitation

2. Muscle pain

3. Frequent yawning

4. Insomnia

5. Anxiety

6. Nausea

7. Vomiting

8. Abdominal cramps

Ashley McGee, RN, emphasizes that the intensity of withdrawal symptoms can vary from individual to individual, and while the symptoms tend to diminish with time, some individuals may also encounter post-acute withdrawal. This phenomenon involves the delayed emergence of withdrawal symptoms subsequent to completing a substance detox. These symptoms are generally less severe but can persist for a prolonged duration.