What are the long term side effects of taking narcotics?

[Pamster]

Anyone have a good site they can link to for me to research this because I am worried about this because I am only in my late 30's and I doubt my situation is going to improve any time soon because I have to do a lot of things that stress my body like lifting my wheelchair in and out of the car, lifting bags of groceries and the like. :p

Not trying to open a debate about this, so I hope this doesn't flair up into a heated discussion, I just want information on what the long term effect of drugs like vicodin are, not oxycontin (I think the side effects of that drug might be harder on the body then what I take but then again I don't know, hence the need for this thread) vicodin is what I take and I want to educate myself about this and am afraid to ask the pain doc. :confused:

[Pharmacist.steve]

While no one can absolutely state what all the long term effects are ... unmanaged constipation is probably the biggest problem... of lesser problems is sweating, dry mouth, blurred vision, mental confusion
Of course, what would the quality of your life be without your pain meds? In treating any disease state.. it is a risk/reward situation. any medication is trying to bring your body back into what is considered a "normal state".. side effects from doing this .. is going to happen.

Pharmacist steve
www.chronicpainresourcecenter.com

[Pamster]

I am glad that it's not really as bad as I thought it might be. I don't have constipation that often thankfully, but when I had oral surgery and was given something stronger then what I was usually taking I did get constipated. Thanks for the info Steve, glad you were on and saw my question. :)

[Kira]

This is something I have been thinking about lately, too. As I said in my other post, I was just started on MS contin. I am only 27 and my disorder is a genetic thing, and it is thought to be progressive, so it is not going to go away anytime soon. I will probably be on pain meds for a long time and have been wondering just what I got myself into.

I would be interested to hear what people who have been on meds for a while have to say about this.

[MeganLyn]

I too also worry about long term affects. I have been on some sort of pain medication since I think I was about 28 years old or so. I will be 34 in Feb.

I keep on the lowest dose I can. But my quality of life is not what I say is the best. I would love to go off pain meds. I like go, to high dose then I every month I cut back. I do not know what or how this helps me. I take Morphine. But was thinking about going on the patch???

I just had my MRI done again. With all my spine problems, I know have R.A, and my C spine is now worse then my lumbar. I started to get major headachs this past spring. The spine clinic said my C spine is now scroliosis. When before I just had a slight curve. I have spinal stenoises, in my lumbar and Spondy. Now I just had to add in the R.A. So, I do not know what to do?

The reason for the MRI was to see if surgery and what kind of surgery would help. Now, they said they will not do surgery? I do not understand that either.

So, it all goes back to medications again. I cannot stand nor walk for no more then 20 minutes. My legs shake so bad. Now my neck and those darn headachs!
All this leaves me is to try as I have been doing to keep my muscles strong. I ride a stationary bike. Do my exersizes. I guess, just get better pain controll.

But it scare me being on pain meds so long. It scares the crap out of me.

I will find out more on Tuesday when I go in to my doctor to go over my MRI and EMG. That is at my pain clinic and not the spine clinic. The spine clinic only called to tell me what they found in my MRI. And not to drive down to see the surgen because he cannot help me.

LOL, sorry. Guess I went on and on again. Anyway, I do feel the same as you do. Not knowing what the big long term on being on strong meds are.

Great question though! Thank you for bringing this up.
Megs

[Tbackpain1]

Pain medications effects is pretty broad. It has to do with what kinds of pain meds you take, whether they are fixed combination meds (opiate + Tylenol or Ibuprofen), pure opiates, COX-2 inhibitors, or OTC pain relievers. Then you have to look at how the body metabolizes the various medications. Often the biggest concern is that the metabolism of said medications stresses the liver (since most are metabolized that way). And then there are some medications that can cause issues with other organs (eg. Methadone can cause EKG changes to the heart).

If you're concerned about a specific medication, talk with your pharmacist or your PM doc. You can also look up each medication on the Physicans Desk Reference website, where you are able to read the full prescribing information, which covers the metabolism and some of the more specific aspects of the chemistry of the drug on the body. Biggest thing you can do is stay on top of you own specific medications, make sure that you get a yearly physical and have your doc include liver function tests if you're on long term opiate therapy, to make sure your liver isn't becoming stressed out. Oh, and make sure you take good care of your mouth. Dry-mouth is a side effect of many of these medications, and the more dry your mouth gets, the more bacteria you can have present, and that leads to more plaque and cavities. There are products out there that you can use (mouth-wash, tooth-paste) to help against teeth probs.

Good luck.

Theresa

[janie]

Ummm, lemme see...long term side effects?

Being judged weak, or a weenie, cause I have to take any level of opiod to manage conditions that are not operable, but do result in pain/physcial dysfunction. This patient stereotyping is a perfect example of the downside of relying on opiods long term. As a matter of fact, I do believe that I have suffered at the hands of judgemental medical personnel who missed a surgical complication because they thought I shouldn't be "complaining" of anything because I had been "medicated" in recovery. Oh well.

As it concerns physical side effect associated with long term use, I have had no problems that are usually associated with opiods, as I take a 24 hour med that my body does well with. I do try to limit my use of short acting opiods, as those do seem to cause tolerance, and the tummy troubles associated with opiods.

After all these years (I started long acting opiods in my 30s), I have come to the realization that the more lasting, and permanent side effects of meds, haven't come from opiods at all. I have had severe, life changing affects from meds used off-label (anti-psychotics, anti seizure, anti-ds, anti spasmodics) that have resulted in blood sugar problems, weight gain, metabolism shift (wrong direction) and major changes to endocrine function. One med especially, put on the pounds (without any diet/exercise change, really), and that was supposedly supposed to help mediate nerve pain (zyprexa).

I am very careful in my acceptance of off-label use meds anymore to mediate the combination of pain, and neuropathy problems, as I have found that they can have more affect long term, than the simple use of opiods (not containing tylenol, etc). I have, over time, found a anti-seizure, opiod combo that works the best for me.

As the pharmicist Steve pointed out, it is a balance of side effects, usefulness, ability to tolerate a med, against pain levels.

Chronic, unrelieved pain can also put great stress on one's body.

I guess it is a matter of acheiving that balance between tolerable pain levels, and side effects. Controlling our pain levels, ideally should allow us to do things, keep moving and perhaps, with other conservative therapies, keep our bodies from becoming deconditioned, making the quality of our lives better. Seems like it should be simple.

At this point, I am more concerned with how I am viewed by medical professionals, than actual drug side effects, as this long term use, definitely affects how I am veiwed as a person/patient, and clouds their clinical vision of me and resultant diagnostic abilities.:eek:

Best of luck.

[Diandra]

Hi Pamster,
For me, aside from the common problems like constipation, etc, the anecdotal long term side effects of taking long term opiates were hormonal and involved endorphins. I found that after I had taken them for a few years they changed my period and I went into menopause much earlier than the rest of the women in my family and the sweating and hot flashes were much worse. Now, again, that is just anecdoctal but, I also have female friends on long term opiates who also experienced changes in hormones, not just female hormones but thyroid, etc.

Now, the other issue is one that was explained to me by an orthopedic doctor I was seeing who was very sympathetic as I was trying to get off long term use of 120mg daily oxycontin. He explained to me that taking long term opiates actually turns off your own production of endorphins, which is something I did not know and my pain doctor confirmed. So....when you try to get off opiates the pain is even worse and you have to manage your way through that. I did get off oxycontin and it was hard but, I did all I could to manage the endorphins kicking back in and much of that was with the great support of the friends on this forum. I manage my pain now with norco/vicodin as needed and lots of alternative stuff.

I am sure you will find all sorts of medical resources, I just wanted to offer my personal experience.

Take care,
Diandra

[janie]

actually, one can enhance "endorphins" while taking opiods, via getting excercise, having sex (if possible), and getting a good laugh in, even if things aren't that "funny".

again, some of us, just are gonna require some level of pain management long term, which may include any combination of opiods, off label meds, alternative care, chiropractic, etc., and finding what works for some, doesn't guarantee that it will work for anyone else. this is a highly individual effort.

it is a given that if someone can avoid opiods and manage their pain in other fashions, they should. there is no doubt to the affect of opiods on endocrine function (just ask my endo) but, he will also admit, that long term, unmanaged pain is just as harmful to the human body.

as one relies on opiods long term, they may notice less "affect" either due to what seems like tolerance, abuse, overuse, etc., but this may also reflect a combination of aging, disease progression, and that nasty side affect of chronic illness, deconditioning.

opiods themselves (when taken appropriately), aren't necessarily bad, just have to understand what can accompany their use, stay on top of the disease that requires them, and continue to seek alternative care that helps keep their use as low as possible while retaining some level of managed pain/symptoms, allowing a person to still participate in life, and not remain bedridden.

and lastly, opiods, done right, may be more appropriate than continual reliance on invasive surgical procedures, that hasten decline, create more pain/suffering, done just in that long shot hope of avoiding/discontinuing use of opiods. many docs push surgical options, marketing that idea that we will be finally "off of opiods" when, in fact, depending on our chronic illness/condition, the chance of ever being pain free again, is just not in the cards.

we need to be the first ones exercising/insisiting on a realistic view of what is physically attainable. there should be a limit to how many times we buy into one more surgery to "fix" something, that, sadly, may not be "fixable", especially if the only "carrot" is to say we no longer take narcotics.

opiods: balance. intelligent use. compassion for those that require them. realistic goals. very simple.

[Pamster]

Is vicodan a opiad? I don't know if it is or not, but I was taking soma for muscle pain but now there was some study about it with narcotics being bad so they wanted me off it and put me on flexeril which did next to nothing. Now I am on Robaxin for it and it helps. :)

Still I wonder about teeth and narcotics, whether that they effect the calcification of them or not. Mainly because my teeth aren't in the best shape and I am wondering if they are getting effected by the drugs I take to manage pain. :confused:

Thanks everyone for the really great replies, I am so happy we can talk about this kind of thing here. I donn't remember if this forum was here when I first joined in 99" but I am glad it's still here and with great people in it like all of you. Thanks for the empathy. :D

[kennethhoff]

I think the best anwser is the one given by steve. Pain meds will always have side effects. But what is the cost NOT to take them? I have been on one pain med or another for 4 years. I have tried almost everything, at different dosages, had most side effects, but still don't have long term effects. In fact, I am hoping to get a pain pump after talking tommorrow with my pain doc.
So what ARE the costs? Chronic daily pain, depression, anxiety, loss of one's job, loss of financial indeoendence, disability issues, no sleep, loss of family/friend or other relationships, no sex, hardly able to stand for lonegr periods, loss of ability for sports, not able to go out dining or plays or other stuff because of pain, hard to volunteer or go to school, constipation, and list goes on and on and on..... So what IS the cost? I belive if taken correctly, the body can handle itself. If pain meds is what is needed, then that is just what one needs to do in order to function and maintain some type of life. Pain meds can always be tapered and stopped if needed. But no so much chronic pain. Do whatever it takes to help yourself, do your research, do what is best for you regardless of what anyone else thinks (they're not in your body), and pray. A higher power helps a true heart.
Hope everyone is feeling as best as possible today.
Ken

[Pamster]

Thanks for the reply Ken, I definitely agree with you about the cost of NOT taking pain meds being higher then the potential long term side effects. You named all the reasons I sought out a pain management dr. The depression and the pain are enough to almost drive you crazy. Thanks for the reply Ken. :)

[Quakindude]

I was on Percocet for over two years. Coming off that stuff was one of the hardest things I've ever done.

That being said, I'm almost to the point of asking for something again. The doc has no problem and always says, "You Army guys just have to tough it out don't you?"

I started then stopped myself from going to the doc today probably 10 times. My pain level has been unmanagable lately. My work performance hurts due to it, my family hurts because of it and I hurt too.

But that crap is the only thing that makes it so that I'm not contemplating getting on my bike and running into a wall at 100mph.

I HATE taking any thing into my body, drugs or alcohol, that impair me in any way. But it looks like I may have to research this question more myself. Because living without them for the last 6 months has been hellish to say the least.

[Pamster]

Hi Quakindude,

I'm so sorry you're in pain so badly. Do you have a pain management doctor yet? I couldn't tell from your post. I think a lot of us here do have PM Docs and they usually can answer the question of what would work best for you like for me I take hydrocodone and robaxin for pain, I used to take soma but they cited some study that was done showing that narcotic use with soma was bad-however all they said was that the soma stopped working, which it never seemed to NOT work for me so I didn't really understand it, just had to accept that they wanted me to move to something else to help with muscle pain.

I don't know what kind of pain you're in but I can empathize, I really can. I had a bad motorcycle accident when I was eighteen and nearly died. So I have a lot of pain that results form that accident, I lost my leg in it too, all the way to my hip just about so I use a wheelchair to get around. It's not easy to go off and do some things, but I do the best I can. It's easier now then it was before I took pain meds. I definitely do NOT want to go back to that painful place I existed in before seeing the PM doc. I wish you all the luck in finding a compromise that doesn't leave you suffering and doesn't leave you feeling like you're in a fog. I know how that feels and it's no fun.

[Harryinny]

I would surely like to know about the teeth. I have bad kidney stone problems already, and that limits the calcium i can have, that in turn weakens my teeth. No matter the amount of florid, or brushing ect, after 5 years of Hydrocodone 6 a day with varying amounts of Fillers, My teeth have officially gone beyond the point of being saveable. I too would like to know if this Uneducated approach of med management by my orthopedic doctor has caused my teeth to rot out. I thank god every day that i have been given the opertunity to see the PM doctor i have now. I hope to be down to a level 5 someday. Living at a 8-9 for the last 9 years and 5 surgeries later, its about time.

Harry

[Quakindude]

The PM doc the Army sent me to said narcotics were a crutch and that since I had been off of them for a while, he saw no reason to put me back on them. Told me to try meditation, excercises and Ti-Chi. :confused:

[BrokenBladder]

Quakindude it sounds like you need a doctor who understands what pain is all about. Narcotics aren't a crutch for those of us who need them to live any kind of life. I would ask the Army to send you to a different PM doctor and if they want to know why then tell them you need a second opionion. Pain causes so much more stress on our bodies and mentally breaks us down to being completely depressed.
Good luck and keep us posted on how things work out for you. Take Care!!

[Mary K]

I have been on Methadone (15-20mg) for about (9) years now. I have developed Gastroparesis which, if I understand it right, is the slow down of the gastrointestinal tract. I know others taking narcotics are affected with this too as I am on the Gastroparesis board and follow what goes on. Some of the symptoms I have is nausea at any time of the day but especially in the mornings for me. I get bloating of the stomach and pain. Sometimes I sit down to eat and can only take a bite or two and I am full. If I force myself to eat more I get nauseous. I am under the care of a Gastroenterologist and take Reglan to help with the side effects.

[LLH]

Well folks, I stumbled upon this web site because I was searching for information on Auto-Immune Hepatitis. That is, toxic hepatitis from the pain meds I was on for almost 10 years. I don't think anyone on this particular thread has tried anything I haven't tried. I just wanted to put this out there for anyone who wanted the info: After 13 oral & maxillo-facial & TMJ & dental surgeries, I think I have been on every pain med known to humankind! The pain clinics said they were 'tired' of being my band-aid because it was just short-term help at best. I saw the top 3rd physician on the planet for oral surgery---UCSF flew him in & he did a case study of my situation because I was UCSF's "worst-case" scenario. Bottom line--I was told to get through life any way I can, take whatever pain meds I could find relief from, and to quit the surgeries now, before I ended up needing to drink every meal the rest of my life. My list of diagnosis reads like an ingredient list, from the Fibromyalgia, TMJD, spinal cord injury, and on & on...I spent years going to holistic drs, was eating poison ivy, did the laying of hands to channel energy, bio-feedback, diet, massage etc...You name it, I tried it. I tried drugs from the Duragesic Patch (which got me out of bed & gave me back my life) to oxycontin to vicodin, then methadone. Now, 3 years later, while on methdone & vicodine as needed, 2 times each day, I go in for my annual exam, and bam. My liver is toxic with auto-immune hepatitis, my blood work is crazy, my heart's in trouble, my thyroid's run amock, and I am sure I am leaving out a few other issues. The point is....I stopped taking my Vicodin with Tylenol, and my liver enzymes went from 300 down to 110 in 6 weeks. Keep in mind, liver enzymes at 500 is like liver failure according to what my dr just told me. It turns out that all these years I was taking Vicodin for the pain, taking regular tylenol, Ultram, all that medication that effects the liver, and I gave myself toxic hep from the drugs! For 10 years my lab work was normal, then all of the sudden, my liver had taken all it could take. I hope those of you out there find meds that do not harm your liver. Methadone does not seem to have any hepatic consequences, and my liver continues to get better while still taking it. I just wanted to put this out there, because for YEARS, I asked the doctors if all the meds could be hurting my liver, and they all said NO. They said it would take a LOT of tylenol to do damage to my liver. Well, I guess I have reached that "LOT" stage...Please look out for your own lives, and listen to your bodies. I did the shrinking of the pain, imagery, yoga, breathing, etc. At 20 years of sobriety, I was ready to go insane from my pain a few days ago and take a hand full of vicodin just to make it stop hurting---just for a brief moment! Don't forget, pain is also a mood alterer. It alters my emotions, my mind, my body & strength, and it alters my relationships with others...All the anti-depressants I took never touched the pain I was in. I wasn't depressed, I was in pain!!! Anyway, thanks for listening! I am scheduled for a liver biopsy in January, to see what new drugs I now have to take to treat my toxic hepatitis from the pain meds I took! Talk about a vicious cycle, huh?! Please inform yourselves with the info on pain meds, and which ones can hurt your liver---especially those of you that live in chronic **** every day like me. The heart condition I was having---guess what? It too was related to medication toxicity! Be careful you guys....

[illusion129]

This is just my personal opinion and bits and pieces of what I've read around...

You probably had the toxic hepatitis due to all of the Acetaminophen. Narcotics, especially those formulated towards more natual occuring substances such as Morphine, are quite gentle over all on the body. Sure, after years and years I'd say the Liver enzymes might be elevated, but only something strong and proven hard on the liver like Tylenol over just a few years would be more than likely the cause of toxic hepatitis.

Perhaps if what I read what wrong PharmSteve can come along and correct for me.

I've always been on the safe side though. When I first started out on opiate pain relievers, I took Vicodin. Then up to Perococet. I only stayed them on a few months until the doctor put me on the long-acting opitate Oramorph (only Morphine). I use OxyIR (Percocet 5 minus the acetaminaphen) for BT pain because I've always known what high doses of APAP over long periods of time can do.

If any of you are on Hydrocodone or Oxycodone plus acetaminophen for BT pain and you're worried about the whole tylenol/toxic liver stuff, just ask your doctor to switch you to OxyIR 5mg capsules. They're just like a Perc 5 but they don't have the APAP. I switched because in my case any opiate mixed with APAP always made me jittery and aggitated...to the point of major insomnia.

[Pamster]

I'm scared of going any higher then what I take currently, vicodin 10/350 (called lorcet) and Robaxin for muscle pain. I don't think my PM doc would agree to give me anything higher either. I am so paranoid about getting to a point to where I have withdrawel symptoms or something because I am worried insurance might change and suddenly stop covering something I would be dependant on. :(

Wow LLH, that sounds like you've been through the ringer. I am sorry you're still in pain and that you've got to have that biopsy done. I definitely am worried about taking tylenol every darn day mixed in with the pain medicine I need to function properly. I wish you luck on this new battle you've got to face. Take care and if you're needing to talk about the pain we're all here for you. Welcome to the family. :)