Opioid Side Effects

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

All medications, including opioids, have potential side effects that need to be considered. The distinction lies in the fact that opioids, unlike many other commonly used medications, have a high risk of addiction. Substance Abuse and Mental Health Services Administration cautions that this addiction risk can lead to misuse or even overdose.

When considering the use of opioids for pain management, it is crucial to have an open discussion with your doctor. They will assess your specific situation and determine if a short-term course of opioid medication is appropriate. It is important to be well-informed about the potential side effects of opioids to make an informed decision, weighing the benefits against the associated risks.

What Types of Opioids Can Cause Side Effects?

To comprehend the side effects of opioids, it is essential to have a brief overview of these medications. Opioids encompass a class of drugs that are prescribed by healthcare professionals to alleviate moderate-to-severe pain. However, it is important to note that some opioids are also illicitly manufactured and distributed for their euphoric effects.

Prescription opioids are intended for legitimate medical purposes and are administered under the guidance of healthcare providers. They can effectively manage pain but carry potential risks and side effects that need to be considered. On the other hand, illicit opioids, such as those obtained illegally or sold on the street, are highly dangerous and pose significant health risks due to their unregulated production and unpredictable contents.

Understanding the distinction between prescribed opioids and illicit opioids is crucial in promoting safe and responsible use of these medications. It is always advisable to consult with a healthcare professional for proper assessment, appropriate pain management strategies, and to minimize potential risks associated with opioid use.

Prescription opioids

The opioid category encompasses various types of drugs, including natural opioids like morphine and codeine, semi-synthetic opioids such as oxycodone, hydrocodone, and oxymorphone, as well as synthetic opioids like fentanyl, which is marketed under brand names like Actiq, Duragesic, and Sublimaze.

Fentanyl, according to the National Institute on Drug Abuse (NIDA), is an extremely potent opioid, reported to be 50 to 100 times more potent than morphine. While prescription opioids have the potential to induce a euphoric sensation that can lead to addiction, they are generally safe when used for a short duration and under the supervision of a healthcare professional, as outlined by the CDC. It is important to follow the prescribed dosage and directions to minimize potential risks associated with these medications.

Illegal opioids

The opioid category encompasses various substances, including heroin, which is derived from morphine and can be consumed through smoking, sniffing, injection, or snorting. Heroin rapidly binds to opioid receptors in the body responsible for functions such as pain perception, pleasure, heart rate, and breathing, as highlighted by the National Institute on Drug Abuse (NIDA).

Illicitly produced fentanyl, which may be available as a powder, nasal spray, or pill, exhibits similar effects on the body as other opioid painkillers. However, it carries a significantly high risk of overdose, as stated by the US Drug Enforcement Agency (DEA).

Beyond the potential for euphoria, opioids pose serious risks. The risk of overdose is a prominent concern, with the CDC Injury Center reporting nearly 50,000 deaths involving opioids in drug overdoses in the United States in 2019.

Furthermore, the side effects associated with opioids are extensive and can vary among individuals.

Side Effects of Short-term Use

The side effects of opioids can significantly differ from person to person, influenced by factors such as duration and dosage of use. Nevertheless, there are several general opioid side effects that are important to be aware of.

Ashley McGee, RN, the vice president of nursing at Mountainside, a drug addiction treatment provider serving New York, New Jersey, and Connecticut, highlights some short-term side effects of opioid use. These can include:

1. Nausea: Opioid use can cause feelings of nausea, which may lead to the urge to vomit or an overall sense of queasiness.
2. Decreased respiratory rate: Opioids can depress the respiratory system, resulting in a slower breathing rate. This can lead to shallow or labored breathing and potentially compromise the oxygen supply to the body.
3. Unconsciousness: In some cases, high doses of opioids or the combination of opioids with other substances can result in loss of consciousness or a state of being unresponsive.
4. Increased drowsiness: Opioids can induce drowsiness and extreme sleepiness, often causing individuals to feel excessively tired or lethargic.
5. Pinpoint pupils: One distinctive sign of opioid use is pinpoint pupils, where the pupils appear constricted or significantly smaller than usual. This occurs due to the impact of opioids on the muscles of the iris.
6. Constipation: Opioid use commonly leads to constipation, as opioids slow down the movement of the gastrointestinal tract, resulting in difficulty or infrequent bowel movements.

In certain cases, these side effects may necessitate an additional treatment approach. Harvard Health Publishing states that constipation occurs in 41% of individuals using opioids for chronic noncancer pain and in 94% of those using opioids for cancer-related pain.

Health professionals often address the issue of constipation when prescribing opioids for pain management. Angela L. Robinson, LPCMH, NCC, the clinical director at NorthNode Group Counseling in Dover, Delaware, explains that healthcare providers commonly prescribe or recommend laxatives alongside opioid prescriptions to mitigate constipation-related discomfort. Constipation can cause significant pain and discomfort, leading some patients to discontinue opioid use.

It is important to note that more potent opioids, such as fentanyl and heroin, may have more severe side effects. The National Institute on Drug Abuse outlines some of the side effects associated with fentanyl, including drowsiness, nausea, constipation, confusion, and breathing difficulties.

Considering the potential side effects and their management is crucial when utilizing opioids for pain management, and it is essential to maintain open communication with healthcare professionals to ensure effective pain control and minimize any adverse effects.

Heroin, a highly addictive illicit opioid, can induce various short-term side effects. The National Institute on Drug Abuse (NIDA) highlights the following immediate effects associated with heroin use:

1. Fluctuations in consciousness: Heroin use can cause individuals to move in and out of consciousness, leading to periods of wakefulness and drowsiness.
2. Dry mouth: A common side effect of heroin use is a sensation of dryness in the mouth, often accompanied by increased thirst.
3. Flushed skin: Heroin can cause the skin to appear flushed or red in color due to changes in blood flow.
4. Heavy limbs: Users may experience a sensation of heaviness or weakness in their limbs, making movements feel sluggish or difficult.
5. Nausea: Heroin use can provoke feelings of nausea, potentially leading to an inclination to vomit.
6. Vomiting: In some cases, heroin use can trigger episodes of vomiting, adding to the overall discomfort.
7. Severe itching: An intense itching sensation, also known as "itchy skin," is a common side effect of heroin use, which may lead individuals to scratch their skin excessively.

Side Effects of Long-term Use

Chronic opioid use, particularly in the case of long-term heroin use, can result in a range of additional side effects. The National Institute on Drug Abuse (NIDA) provides insights into the extensive effects of prolonged heroin use:

1. Insomnia: Chronic heroin use can disrupt normal sleep patterns, leading to difficulties in falling asleep or staying asleep.
2. Collapsed veins: Repeated injection of heroin into veins can cause damage to the veins, resulting in their collapse or becoming nonfunctional.
3. Damaged nose tissue: Snorting heroin can lead to the deterioration of nasal tissue, potentially resulting in perforation of the nasal septum.
4. Constipation: Opioids, including heroin, commonly cause constipation by slowing down bowel movements and reducing intestinal motility.
5. Stomach cramping: Chronic opioid use may lead to persistent abdominal pain and cramping.
6. Liver and kidney disease: Prolonged heroin use can contribute to the development of liver and kidney problems, potentially resulting in liver disease or kidney dysfunction.
7. Pneumonia: Individuals who use heroin are at an increased risk of developing pneumonia due to compromised respiratory function and weakened immune responses.
8. Depression: Long-term opioid use, including heroin, can contribute to the onset or exacerbation of depressive symptoms.
9. Sexual dysfunction: Opioids can interfere with sexual function, leading to difficulties in arousal, performance, or satisfaction.
10. Irregular menstrual cycles: Female individuals using opioids long-term may experience disruptions in their menstrual cycles, including irregularities in timing or intensity.
11. Withdrawal symptoms: When discontinuing or reducing opioid use, individuals may experience a range of withdrawal symptoms, such as cravings, anxiety, nausea, and muscle pain.

Robinson emphasizes that long-term opioid use can result in behavioral changes, with individuals becoming hyper-fixated on opioids and their next dose. Additionally, the body may develop heightened sensitivity to pain due to pain suppression and loss of natural tolerance.

Opioid Withdrawal

Opioid withdrawal can occur rapidly due to the highly addictive nature of these substances. Mayo Clinic warns that after as little as five days of opioid use, the risk of developing dependence significantly increases.

The US National Library of Medicine outlines several common side effects associated with opioid withdrawal, which can include:

1. Agitation: Individuals may experience restlessness, irritability, and a sense of unease.
2. Muscle pain: Muscles throughout the body may feel achy or tender.
3. Yawning: Frequent yawning is a characteristic symptom of opioid withdrawal.
4. Insomnia: Difficulties in falling asleep or staying asleep may be present.
5. Anxiety: Feelings of apprehension, nervousness, or worry can be prevalent during withdrawal.
6. Nausea: A sensation of queasiness and the urge to vomit may occur.
7. Vomiting: Some individuals may experience episodes of vomiting.
8. Stomach cramps: Abdominal discomfort and cramping can be common during withdrawal.

According to McGee, the severity and duration of withdrawal symptoms can vary among individuals. While symptoms tend to improve over time, some individuals may experience post-acute withdrawal, which refers to the delayed onset of milder withdrawal symptoms following the completion of detoxification. These symptoms are generally less severe but may persist for an extended period.

It is crucial for individuals using opioids long-term to engage in non-opioid pain management strategies, as relying solely on opioids may worsen pain sensitivity over time. Furthermore, it is important to be aware that constipation can persist and become more severe with prolonged opioid use. Seeking comprehensive medical guidance and support is essential for individuals navigating the challenges associated with long-term opioid use.