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.

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.

[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.

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.

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.