Opioids are powerful painkillers which can be a blessing or a curse. However, the risks of combining opioids with your other medications may cause irreversible damage.
It’s a bad mix.
If you’re in severe pain after surgery or an injury, opioids like Morphine, Fentanyl, Hydrocodone or Oxycodone can be a godsend.
But…become dependent on them, and the consequences can be deadly.
It’s an alarmingly growing problem.
For example, when taking these common medications together with opioids, their strength multiplies:
➡ Xanax®, Klonopin®, Valium® and Ativan® are commonly prescribed for anxiety. But, like opioids, they also reduce your respiratory rate and can be addictive.
➡ Ambien® and Lunesta® are popular remedies when you’re struggling with poor sleep. But because they decrease your respiratory rate, they’re not safe to take with opioids.
➡ Medications like Soma® may be prescribed for muscle pain. But they’re unsafe to use with opioids because they can also cause increased sleepiness and reduce your respiratory drive.
In the majority of cases, doctors don’t knowingly prescribe such drugs together. It happens unintentionally.
For example, a patient may fill a benzodiazepine prescription from their primary doctor. Then, maybe months later, they’ll fill an opioid prescription from their pain doctor.
The responsibility for preventing this, however, goes both ways.
➡ Your physicians should request and examine a complete and updated list of all your medication at each office visit.
➡ If you are not asked for such a list, the responsibility is yours to inform them if new medications are prescribed that could potentially interact negatively with your regular ones.
Why opioids are the go-to pain drug
Other pain medications are less addictive and cause fewer interactions. So why have opioids become so popular?
➡ If you’re in severe or chronic pain, it’s like using a shotgun instead of a rifle…They have a broad effect on many different types of pain.
In contrast, other medications help only with specific types of pain. For example, medication for nerve pain won’t work for inflammatory pain, and vice versa.
➡ However, due to potentially deadly interactions with other medications, physicians are urged to prescribe opioids only as a last resort.
If you prefer not to use opioids, the following alternatives may be effective in reducing or eliminating your pain, in particular for the following 3 conditions:
Surprisingly, the tricyclic antidepressants also help relieve to nerve pain. They include:
➡ Amitriptyline oral tablets are available as a generic drug. It’s not available as a brand-name drug. It is used to relieve symptoms of depression.
FDA warning: This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
➡ Your doctor and family members should watch you closely for signs of changes in your behavior or worsening depression when you start taking this drug.
➡ Worsening depression warning: You might experience an initial worsening of your depression, thoughts of suicide, and behavioral changes when you first start taking amitriptyline. This risk may last until the drug starts working for you.
➡ Withdrawal symptoms warning: If you’ve been taking this medication for a long time, you should NOT stop taking it suddenly.
➡ Stopping these medications can cause severe and persistent nausea, headaches, and tiredness.
➡ Dementia warning: Research has indicated that this type of medication can raise your risk of dementia.
Other side effects of anticholinergic medications include dry mouth and related dental problems, blurred vision and a tendency toward overheating.
Serotonin-norepinephrine reuptake inhibitors:(duloxetine).
➡ This medication is also prescribed for depression, but also helps reduce physical pain.
The same is true for anticonvulsants such as Gabapentin (Neurontin) and Pregabalin (Lyrica)
➡ Pregabalin is used to treat pain caused by nerve damage due to diabetes or to shingles (herpes zoster) infection.
➡ It may also be used to treat nerve pain caused by spinal cord injury. This medication is also used to treat pain in people with fibromyalgia.
➡ It is also used with other medications to treat certain types of seizures (partial-onset seizures).
Or your doctor may prescribe diclofenac (Voltaren, Cataflam).
All non-steroidal anti-inflammatory drugs dull the pain of inflammation from arthritis. But you’re at risk of NSAID complications if you have cardiovascular disease, kidney disease or gastrointestinal bleeding.
➡ Heat, stretching and physical therapy are effective alternatives for musculoskeletal pain. Sometimes, muscle relaxants can be used for the short term.
Worried about drug interactions?
Talk to your doctor’s office or neighborhood pharmacist if you’re concerned that a painkiller may interact with your other medications. Your pharmacist can work with your physician to problem-solve and explore alternatives.
But be sure to talk to your physician if you’re worried about how you or someone you love is taking pain medication, as it may be a sign of addiction.