2023-08-15 09:30:00
Medicines
Published: 8/15/2023 Last updated: 8/15/2023
Published: 8/15/2023 Last updated: 8/15/2023
Opioids are analgesic drugs used in cases of severe pain.
Opioids are a group of analgesic drugs used to relieve acute or chronic pain.
They can be natural, synthetic or semi-synthetic, acting in different ways and with varying intensities.
The use of this type of medicine generates a lot of discussion among specialists, since its side effects can be intense, in addition to the risk of addiction.
Keep reading to understand a little more about this topic.
Index
What are opioids for?What conditions can they be prescribed for?Mechanism of actiontypesContraindicationsSide effectsComplications and risksDependency
What are opioids for?
Opioids are used to reduce pain. They have an intense and fast action, and can be indicated in cases of chronic or acute pain, when lighter action analgesics are not enough.
Within this group, they can still be divided into weak or strong, with varying intensity of action.
Natural opioids are extracted from the poppy plant or produced by the human body itself, while synthetic ones are developed in laboratories. The semi-synthetics are a combination of the first two.
Among the drugs that are part of this group, we can mention morphine, methadone, oxycodone, nalbuphine and fentanyl.
What conditions can they be prescribed for?
Opioids are generally indicated for patients with neuropathic pain (chronic pain in the nervous or peripheral system), lumbar and head pain, trauma, arthritis, in anesthesia, pre- or postoperatively and in the treatment of cancer patients.
This type of drug can be used in several other situations, and its use must be guided by a professional, who will assess the risks and benefits.
Do opioids need a prescription?
Yes, opioids can only be purchased with a prescription. Some drugs of this type require a prescription in two copies, while others need the model that accompanies registration and has health surveillance control.
Read more: Digital recipe: what it is, benefits and validity
Mechanism of action
The action of opioids takes place in the central nervous system. They connect with so-called opioid receptors present in different places, such as the brain, spinal cord and organs.
They can act in different ways, which are summarized in the inhibition of the neurons responsible for pain.
Many of these receptors are related to the gastrointestinal tract and the dopaminergic system, associated with motivation, pleasure and reward.
types
Opioids can be classified into a few types. The traditional division divides them according to the intensity of the action:
Weak; Intermediate; Strong.
If separated according to their origin, the types are:
Natural;Semi-synthetic;Synthetic.
Finally, there is the division by functionality, with four groups:
Pure Agonist; Partial Agonist; Agonist-Antagonist; Pure Antagonist.
Morphine, for example, one of the most well-known opioids, is classified as a strong, natural, and pure agonist.
Contraindications
Each type of opioid may have specific contraindications, as they act in different ways. However, in general, they are not indicated for pregnant women, as they can cross the placenta and gain access to the fetus.
Some drugs in this group may not be recommended for children, the elderly, people diagnosed with asthma or a related illness.
When indicating an opioid, the responsible professional must analyze all the risks and consider the contraindications of each drug.
Read more: Medicines in pregnancy: know which ones to avoid
Side effects
Opioids can cause different side effects, which vary according to the type, dose ingested and other factors. The following stand out:
Drowsiness and altered consciousness; Sedation; Hallucinations; Euphoria or dysphoria (feeling anxious and restless); Nausea and vomiting; Excessive pupil contraction; Respiratory depression (irregular and slow breathing); Constipation; Allergic reactions such as itching; Reduced efficiency of the immune system; Change in tolerance and dependence.
Complications and risks
Adverse reactions that may be triggered by the use of opioids are already risks that should be considered by the physician when prescribing a drug from this group. They may vary according to the type of action of each drug on the nervous system and the amount used.
Tolerance to the drug is one of the main ones. What happens is that the body gets used to the drug and it stops having the desired effect. When this happens, it may be necessary to increase the dose gradually.
However, medical follow-up is necessary precisely so that this administration is carefully evaluated, since the higher the dose, the greater the chances of side effects appearing, as well as their intensity.
In the case of pregnant women, the use of opioids can lead to dependence on the fetus, since they have the ability to cross the placental barrier. Another complication is respiratory depression in the baby soon after birth, if the drug is used during delivery.
In addition to those already mentioned, opioids also pose a risk that should not be ignored, which is dependence. Understand more below.
Dependency
Dependence or addiction to opioids is a relatively common problem, and is related to the release of dopamine caused by the drug, which causes a feeling of well-being.
Different factors can make a person more likely to develop dependence, such as genetic predisposition, social context, psychological profile, previous history of licit or illicit drugs, age, gender, level of drug use, etc.
Dependence on opioids presents several risks, starting with the fact that, in these cases, the individual does not have medical advice to use the drugs properly.
Thus, it is vulnerable to side effects, especially if the dose used is high. If mixed with certain other substances, opioids can trigger a syndrome that causes symptoms such as confusion, agitation, tremors, spasms, sweating and fever.
Overdose can cause severe respiratory depression, causing lung failure, with a reduction in temperature, pressure and heart rate. This painting can be fatal.
People with opioid dependence may also experience withdrawal after stopping use, with symptoms including rapid breathing, sweating, increased heart rate and blood pressure, pain, malaise, anxiety and agitation.
Treatment
Patients who become dependent on opioids need to go through treatment processes that may vary from case to case.
They may involve reducing the dose gradually so that detoxification occurs or stopping it abruptly, changing the type of medication, emergency actions in case of intoxication, or rehabilitation, with programs that work in the physical and psychological areas.
Opioids can be very necessary to reduce severe pain, allowing adequate treatment and well-being to patients in different contexts. However, use should be made with caution and always under medical guidance and monitoring.
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