Opioid painkillers: must-know facts about fentanyl and other types

Opioids are a strong form of painkillers, which are usually used in patients in severe pain, such as back pain or cancer pain.

Why have opioid painkillers been in the news?

Fentanyl is a strong opioid painkiller. Usually used as an analgesic, it was the mediation which led to music star Prince's death in April. Fentanyl is available in different formulations, such as patches, lozenges, sublingual tablets, buccal tablets and a nasal spray. The patch is usually changed every three days and is designed for long-term use.

How do opioid painkillers work?

Opioids bind to opioid receptors to block pain pathways in your brain to therefore reduce how you feel pain.

How addictive are opioid painkillers?

Opioids have a tendency to be regularly abused due to their euphoric side effects. This ongoing abuse of the medication can cause addiction and dependence.

What are some other common opioid painkillers?

Codeine is a form of weak opioid. It is available over the counter in community pharmacies as co-codamol (codeine and paracetamol). Morphine is a strong opioid painkiller, it is used in patients who suffer from severe pain, acute or chronic. Examples of acute pain are a broken leg or hip and chronic pain - back pain or cancer.

What are the side effects of opioid painkillers?

Drowsiness is a common side effect of opioid use; however, this can be dose- dependent. It is not advised to drive or operate heavy machinery when on opioid medication. Opioids can cause other side effects, such as:

· Respiratory depression - it's important for patients with respiratory problems to talk to a healthcare professional before taking opioids

· Nausea and vomiting - this can subside; however anti-emetic medication can be co-prescribed if it is persistent

· Constipation - this can be caused due to opioids having an effect on intestinal motions. It reduces intestinal secretions and therefore stools can become hard and dry. Laxatives can be prescribed to help stool motions.

What are the withdrawal symptoms of opioids?

Suddenly stopping opioid medication can cause withdrawal symptoms if they have been taken regularly and over a long period of time. The severity of the withdrawal symptoms is dependent on each individual and drug they are taking. Symptoms include, but are not limited to, nausea, sweating, anxiety, muscle tremor and an increased heart rate.

References:

Walker, Roger. Clinical pharmacy and therapeutics. Elsevier Health Sciences, 2011. https://www.medicinescomplete.com/mc/martindale/current/6200-n.htm?q=opioids&t=search&ss=text&tot=166&p=2#_hit 



Yasmin Karsan is a UK registered pharmacist who has a pharmacy-related blog,
Ask a Pharmacist, and an Ask a Pharmacist YouTube channel. Follow @YasminKarsan on twitter, Ask a Pharmacist on Facebook or Askapharmacist on Instagram.