What are Opioids and How Do They Work

Opioids are powerful medications that produce morphine-like effects, including pain relief, euphoria, drowsiness, and slowed heartbeat. Many people use the terms “opioid” and “opiate” interchangeably. “Opiate”, however, is used specifically for medicines made from opium, a derivative of the poppy plant. They form part of the overall opioid class, which also includes synthetic and semi-synthetic medications. Common opioids include oxycodone, tramadol, fentanyl, and codeine.

Opioids bind to receptors in the nervous system, blocking pain sensors and relaxing the body. They are generally highly effective, which is why they are very commonly used in pain management and treatment. Some people may not tolerate certain opioids well, due to side effects like nausea and drowsiness. Others may need larger or smaller doses than standard, depending on factors such as age and genetics. Your doctor will help you determine this and work through any issues you may have.

Most people take opioids as oral pills or capsules. Transdermal patches, injections, and IV drips are also common delivery methods.

Opioids for Short and Long Term Pain Management

Many people first encounter opioids when dealing with moderate or severe short term pain, also called acute pain.

Acute pain usually comes from a traumatic injury, serious illness, or a medical procedure such as surgery. In these cases, doctors prescribe a brief course of medication to help patients rest and heal more comfortably. For moderate pain, this is often a few days or weeks of oral medication taken at home. In hospital settings, patients often receive IV medication under the supervision of medical staff.

Long term (chronic) pain is any pain that lasts 12 weeks or longer (as defined by the National Institutes of Health). Chronic pain comes from many sources, including injury and underlying illness, though it can also occur without an identifiable cause. Opioid treatment for chronic pain management is a complex issue and the subject of much discussion in the medical community.

The Centers for Disease Control (CDC) highly recommend avoiding opioids as the sole method for controlling chronic pain. Instead, opioids should form part of a more holistic treatment plan that focuses on non-medication therapy (like diet and exercise) and non-opioid medications.

Opioid Treatment and Your Pain Management

So can opioids help manage your chronic pain?

The first step in answering this question is to work with your healthcare team to develop a personalized, comprehensive treatment plan. You should discuss topics such as:

  • The causes of your chronic pain
  • Treatments you have already tried, including any past use of opioids
  • Realistic goals for long term pain reduction and prevention
  • How you will measure progress towards these goals

The focus of this plan should be sustainable treatment methods. Often this is a combination of medications, psychological therapy, physical therapy, and lifestyle changes such as a modified diet or exercise regimen.

As Dr. Hooten of the Mayo Clinic states, that adding “non-opioid approaches to managing chronic pain can offer more effective pain relief that lasts longer and allows people to maintain a higher quality of life.” The key, as with everything, is in the approach.

Opioids have also proved effective in long term treatment of cancer pain. Your doctor will help you decide which medication would be most effective and how long you should take it. Once your treatment plan is in place, you should have regular meetings with your team to assess your progress and make any necessary adjustments.

The most important thing is that you understand and be comfortable with any treatment you pursue, including the expected benefits. Don’t be afraid to share any concerns or questions you have with your healthcare providers. Being informed and confident will help you be as proactive and successful as possible in your long term pain management plan.

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