Taking narcotics for back pain

Nonspecific back pain - narcotics; Backache - chronic - narcotics; Lumbar pain - chronic - narcotics; Pain - back - chronic - narcotics; Chronic back pain - low - narcotics

Definition

Narcotics are strong medicines that are sometimes used to treat pain. They are also called opioids. You take them only when your pain is so severe that you cannot work or do your daily tasks. They may also be used if other types of pain medicine do not relieve pain.

Narcotics can provide short-term relief of severe back pain. This can allow you to return to your normal daily routine.

Narcotics work by attaching themselves to pain receptors in your brain. Pain receptors receive chemical signals sent to your brain and help create the sensation of pain. When narcotics attach to pain receptors, the medicine can block the feeling of pain. Even though narcotics can block the pain, they cannot cure the cause of your pain.

Names of Narcotics

Narcotics include:

  • Codeine
  • Fentanyl (Duragesic) - which comes as a patch that sticks to your skin
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Morphine (MS Contin)
  • Oxycodone (Oxycontin, Percocet, Percodan)
  • Tramadol (Ultram)

Taking Narcotics

Narcotics are called "controlled substances" or "controlled medicines." This means that their use is regulated by law. One reason for this is that narcotics can be addictive. To avoid narcotics addiction, take these medicines exactly as your health care provider and pharmacist prescribe and direct.

Do not take narcotics for back pain for more than 3 to 4 months at a time. (This amount of time may even be too long for some people.) There are many other interventions of medicines and treatments with good results for long-term back pain that do not include narcotics. Long-term narcotic use is not healthy for you.

How you take narcotics will depend on your pain. Your provider may advise you to take them only when you have pain. Or you may be advised to take them on a regular schedule if your pain is hard to control.

Some important guidelines to follow while taking narcotics include:

  • Do not share your narcotic medicine with anyone.
  • If you are seeing more than one provider, tell each one that you are taking narcotics for pain. Taking too much can cause an overdose or addiction. You should get pain medicine from only one provider.
  • When your pain begins to lessen, talk with the provider you see for pain about switching to another kind of pain reliever.
  • Store your narcotics safely. It is your responsibility to take care of this regulated substance. Keep them out of reach of children and others in your home.

Common Side Effects of Narcotics

Narcotics can make you sleepy and confused. Impaired judgment is common. When you are taking narcotics, do not drink alcohol, use street drugs, or drive or operate heavy machinery.

These medicines can make your skin feel itchy. If this is a problem for you, talk with your provider about lowering your dose or trying another medicine.

Some people become constipated when taking narcotics. If this happens, your provider may advise you to drink more fluids, get more exercise, eat foods with extra fiber, or use stool softeners. Other medicines can often help with constipation.

If the narcotic medicine makes you feel sick to your stomach or causes you to throw up, try taking your medicine with food. Other medicines can often help with nausea, as well.

References

Dinakar P. Pain management. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 52.

Hobelmann JG, Clark MR. Substance use disorders and detoxification. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 47.

Nagpal AS, Boies B, Clements N, Vydra D. Opioids in pain. In: Pangarkar S, Pham QG, Eapen BC, eds. Pain Care Essentials and innovations. St Louis, MO: Elsevier; 2021:chap 16.

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Review Date: 8/12/2023

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


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