Watkins Medical Centre
Level 8, 225 Wickham Terrace,
Spring Hill QLD, 4000

All appointments
Phone: (07) 3831 7034

Narcotic drugs

Narcotic drugs -(also called Opiods) are all either made from an opium poppy or are synthetic drugs that share most of the characteristics of naturally occuring opiates.   Examples of narcotic drugs are:

     

  • Morphine
  • Pethidine
  • Fentanyl
  • Oxycodone
  • Hydromorphone
  • Codeine
    • Dextropropoxyphene
    •  

    Different drugs have different potency - with Codeine being the least potent and Fentanyl and Morphine being the most potent. In general less potent drugs tend to be less addcitive.
    All narcotics share similar characteristics:

       
    • Powerful pain killers
    • High risk of addiction
    • Development of tolerance (the need to increase the dose to have the same effect over time)
    • Risk of Opiod induced hyeralgesia (see below)
    • Relatively high risk of nausea

    Narcotic drugs have two uses:

    • Acute (of recent onset - a few days or weeks) severe pain.
    • Chronic pain - pain that persists for months.
         

    Narcotic drugs are excellent for the treatment of severe acute pain - such as sciatica or arm pain associated with disc herniation.
    Their use in chronic pain is more of a problem. Sometimes this is the only thing that will control the pain and most doctors will prescribe this medication though there are many problems with this approach and the problems need to be weighed carefully against the benefits

      Opiod Induced Hyperalgesia

        This condition is poorly understood by researchers and doctors. It appears that some people who take regular opoids develop a lower pain threshhold. This means that despite taking strong pain killers, the pain actually gets worse. It is characterized by an increase in the original pain and by the pain seeming to 'spread out' to affect a larger area. People with this condition often also describe pain with things that wouldn't normally cause pain - such as touching the skin. The condition is particularily troublesome as doctors don't know if the increase in pain is due to a worsening of the underlying problem (which might need a higher dose of narcotics) or if it is Opiod induced hyperalgesia (which will worsen if the opiod doses is increased)


        This condition can be particularily difficult to manage in patients who need surgery. The normal post operative pain is usually increased.