What are opioids? How to avoid addiction and use them safely?

Sometimes, when you have unbearable pain, your doctor may prescribe a stronger painkiller. These are used for severe pain that is difficult to control with regular painkillers, such as pain after surgery or cancer pain. We commonly call these types of drugs 'opioids'. They provide great pain relief, but we need to be a little more aware of these drugs and use them with great care. Because while they are useful, they can also be addictive if not used properly. So today, let's talk about all about these opioids.

Are opioid and opiate the same thing?

You may have heard both of these words. There is a slight difference between the two. Simply put, opiates are chemicals that are naturally derived from the poppy plant (Papaver somniferum). For example, morphine and codeine are types of opiates. Opioids are a broader term. They include those that are naturally derived from the poppy plant, those that are made chemically in a lab (synthetic), and those that are a combination of both (semi-synthetic) - all of these are collectively called opioids. That is, every opiate is an opioid, but not every opioid is an opiate . Think of it like the word 'vehicle'. Cars, vans, and buses are all vehicles. Similarly, opiates also belong to the larger group called opioids. However, the effects of both types on our bodies are similar. And both have the risk of addiction.

How do these opioids affect the body?

Our nervous system has special receptors that control things like pain, mood, and stress. We call these opioid receptors. When you take an opioid drug, it goes straight to these receptors and binds to them. When that happens, two main things happen: 1. It reduces the sensation of pain: It blocks the pain signals going to the brain, reducing the pain you feel. 2. It creates pleasure and relaxation: It increases the production of the neurotransmitter 'Dopamine' in the brain, which makes us feel happy and well. This causes a feeling of great relaxation and euphoria.

Things you should know before a doctor prescribes this medicine

Before you decide to give yourself an opioid, there are some things you need to discuss honestly with your doctor. This is very important for your safety.

Why are these things so easily addictive?

There are several reasons for this. The euphoria we talked about earlier is the main reason. Because the mind craves that feeling, some people continue to take the drug even when the pain is gone. The other thing is the development of tolerance . That is, after using the same dose for a while, in order to feel the pain relief or pleasure that they used to feel, the dose of the drug needs to be increased. As the dose is increased in this way, the body begins to physically depend on the drug. Then, if the drug is stopped, the body begins to experience very unpleasant withdrawal symptoms. To escape this discomfort, the person takes the drug again. This is a dangerous cycle.

How do we use this medicine safely?

Don't think of opioids as something dangerous. If you follow your doctor's instructions exactly , they are very useful and safe.

• Take only the prescribed dose: Never take more than the dose prescribed by your doctor, or take it before the prescribed time.
• Do not change the dosage of the medicine : Do not crush, chew, or dissolve the tablets without your doctor's advice. Doing so can cause the medicine to be absorbed into the body too quickly and can be dangerous.
• Avoid driving: These can cause drowsiness and dizziness , so do not drive or operate dangerous machinery, especially in the early days.
• Do not take with alcohol : Taking opioids with alcohol can cause fatal consequences, such as respiratory arrest.
• Be aware of side effects : If you experience any unusual discomfort, tell your doctor immediately.
• Do not give your medicine to anyone: This is very important. Do not give your medicine to a family member or friend for any reason. It could be dangerous for that person.
• Keep safe: Always keep these in a locked place out of reach of children and pets.

Overdose and emergency

If someone takes too much opioid, it could be an overdose. This is a medical emergency that can be life-threatening. Symptoms of an overdose include:

• Breathing becomes very slow or stops.
• Blue lips and fingernails.
• The body becomes lifeless.
• Falling into a deep sleep, unable to be awakened even by talking.
• The pupils of the eyes are very small (like the tip of a pin).

If you need further information on such poisonings, you can call the National Poison Information Centre at the Colombo National Hospital . An antidote called 'Naloxone' is used in hospitals to reverse an opioid overdose.

Are these suitable for pregnant and breastfeeding mothers?

Opioids are generally not recommended during pregnancy. This is because the medication the mother takes can affect the baby in the womb. The baby can also become addicted to the medication. After birth, the baby can also show withdrawal symptoms (neonatal abstinence syndrome). This is a very painful condition for the baby. Also, this medication can pass to the baby through breast milk. Therefore, if you are a breastfeeding mother, you should definitely talk to your doctor before taking this medication and discuss a safer alternative.