Opiate pain relievers for low back pain

Examples

Generic Name	Brand Name
codeine	Tylenol 3
fentanyl	Actiq
hydrocodone	Lortab, Norco, Vicodin
methadone	Dolophine, Methadose
morphine	Avinza, MS Contin, Oramorph SR
oxycodone	OxyContin, Percocet, Percodan
propoxyphene	Darvocet-N
tramadol	Ultram, Ultracet

Opiates are also called opioids or narcotics.

Opiates are sometimes combined with other medicines. For example, Tylenol 3 is codeine combined with acetaminophen, and Percodan is oxycodone combined with aspirin.

How It Works

Opiates relieve pain by altering the way your body feels pain and the way you feel about pain.

Why It Is Used

Opiates are usually reserved for the treatment of severe short-term (acute) back or leg pain that has not responded to other medicines. Because opiates are potentially addictive, they are usually prescribed only for 1 to 2 weeks.

Sometimes opiates are used for people who cannot take pain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs) because they have conditions such as heart, kidney, or liver problems. Or opiates may be used for people who take other medicines that should not be combined with pain medicines.

How Well It Works

There is no clear evidence that opiates help either acute or chronic low back pain.^{1, 2} They seem to help some people, but sometimes the amount of medicine you need for relief causes side effects that make daily functioning difficult. Further study is necessary.

Opiate pain relievers for low back pain should only be administered by health professionals with experience in chronic pain management. There is a significant potential for addiction and other complications from prolonged use of this type of medicine.

Side Effects

Side effects from opiate pain relievers for low back pain may include:

• Confusion (especially in older adults).
• Drowsiness.
• Nausea.
• Vomiting.
• Constipation.
• Decreased urination.
• Impaired breathing.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Opiates are not intended for use until all pain goes away. They are intended to be used only for a few days to get you through the most severe pain.

You may become physically dependent on opiates if you take them regularly. Physical dependence is not addiction, but rather a gradual change in your body in response to the opiates. If you stop taking opiates abruptly, you may develop nausea, sweating, chills, diarrhea, and shaking. The physical dependence and withdrawal symptoms are not life-threatening. You can avoid withdrawal symptoms if you gradually stop taking the opiates over a set period of time, as prescribed by your doctor.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: February 3, 2010
Medical Review:	William M. Green, MD - Emergency Medicine Robert B. Keller, MD - Orthopedics
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