narcotic

Narcotics

Narcotic analgesics are medications used to treat pain. Narcotics are controlled substances, that is, drugs with moderate to high abuse potential. Pain is one of the most under-treated problems in medicine. This is mainly due to the following reasons:

• fear of addiction: both physicians and patients have this fear; however it has been found that when narcotic analgesics are used as indicated for pain, the potential for addiction (barring pre-existing risk factors) is low. Also, adequate early treatment of pain is directly linked to faster healing and lower overall analgesic use.
• fear of tolerance: i.e. physicians or patients are afraid that if narcotics are used in progressive disease, they will lose their effectiveness.
• fear of physical dependence: Physical dependence is different from addiction. Addiction is psychological dependence on a drug, whereas physical dependence is the presence of withdrawal symptoms when a drug is discontinued.
• fear of respiratory depression: this is only critical when there are respiratory problems, or in head injuries when respirations and the central nervous system are depressed anyway.
• bias of healthcare professionals: many times, medical personnel's perception of the patient's pain differs significantly from the patient's. Patients are easily perceived as whiners, hypochondriacs or addicts by caregivers. The ONLY one who knows how bad the pain is is the patient. Period. End of story. Even if you had the same thing and got by on a baby aspirin a month.
• fear of legal implications: Doctors put their license on the line when they prescribe narcotics, so they are understandably reluctant to prescribe them more than necessary.

A narcotic overdose is treated with a narcotic antagonist, such as Narcan (naloxone) or Trexan (naltrexone).

Narcotic (opioid) analgesics

Brand/Generic Drug Names

Alfenta/alfentanil, Stadol/butorphanol, codeine, Dalgan/dezocine, Duragesic/fentanyl, Dilaudid/hydromorphone, Levo-Dromoran/levorphanol, Demerol/meperidine, Dolophine/methadone, Duramorph or MS Contin/morphine, Nubain/nalbuphine, Roxcodone/oxycodone, Numorphan/oxymorphone, Talwin/pentazocine, Darvocet or Darvon/propoxyphene, remifentanil

moderate to severe pain, preoperative and postoperative analgesia

interact with opioid receptors at spinal cord level depressing pain impulse transmission

allergy, narcotic addiction, acute bronchial asthma, upper airway obstruction

addictive personality, increased intracranial pressure, severe cardiac, renal, hepatic disease, respiratory conditions, seizure disorders

Increased central nervous system depression: barbiturates, narcotics, hypnotics, antipsychotics, alcohol

nausea, vomiting, anorexia, constipation, cramps, light-headedness, dizziness, sedation, respiratory depression, respiratory arrest, circulatory depression, increased intracranial pressure

Assess intake and output, respiratory status, central nervous system status, allergic reaction
Administer antiemetics if vomiting occurs
Provide assistance with walking
Evaluate therapeutic response: decrease in pain

September 09, 2002

Nar*cot"ic (?), a. [F. narcotique, Gr. , fr. to benumb, na`rkh numbness, torpor.] Med.

Having the properties of a narcotic; operating as a narcotic.

-- Nar*cot"ic*ness, n.

© Webster 1913.

Nar*cot"ic (?), n. Med.

A drug which, in medicinal doses, generally allays morbid susceptibility, relieves pain, and produces sleep; but which, in poisonous doses, produces stupor, coma, or convulsions, and, when given in sufficient quantity, causes death. The best examples are opium (with morphine), belladonna (with atropine), and conium.

Nercotykes and opye (opium) of Thebes. Chaucer.

© Webster 1913.