July 23, 2019 / 5:27 PM / 5 months ago

Short-term opioids for pain still come with side effects

(Reuters Health) - Patients who only briefly take opioid painkillers are still likely to face side effects, a new study suggests.

While side effects associated with long-term use of the drugs have been widely studied, this is not the case with patients who take opioids for less than two weeks, said study coauthor Dr. Raoul Daoust of Hopital du Sacre-Coeur de Montreal.

To learn more, Daoust and colleagues studied 386 adults who had been discharged from an emergency department with an opioid prescription, 80% of whom took at least one pill.

More than half the patients who used opioids reported feeling drowsy. Patients also reported side effects like constipation, dizziness, weakness, nausea and vomiting.

Overall, 79% of patients who used the painkillers said they experienced side effects that can be related to these drugs, compared to just 38% of patients who did not use opioids.

The type of opioid being used seemed to affect patients differently. Dizziness, nausea and vomiting were more often associated with oxycodone than morphine, for example.

The side effects of opioids can severely affect patients’ quality of life, sometimes prompting them to discontinue the drugs even though they remain in pain.

Opioid-induced constipation was a particularly persistent problem in the new study. The higher the dose of opioid, the more likely patients were to feel constipated.

“It was surprising to find that 38% of patients had constipation while consuming only a (relatively low dose of opioids) during the first two weeks,” Daoust told Reuters Health in an email.

The study, published in the American Journal of Emergency Medicine, also found that older patients were more likely to experience constipation as a side effect.

Dr. Benjamin Friedman, a professor of emergency medicine at Albert Einstein College of Medicine in New York who was not involved in the new study, said certain people become habituated to some side effects over time, like drowsiness or dizziness.

But this is unlikely to be the case with constipation, Friedman said.

Opioids act on the nervous system and are frequently used to manage both acute and chronic pain. However, they are also known to be highly addictive and opioid overdoses have been linked to thousands of deaths over the last few years.

Despite the risks and the side effects, Daoust believes that opioids should not be avoided entirely.

Instead, he says, patients must be properly informed of the side effects they are likely to face and given advice on how to manage them, such as avoiding driving because of possible drowsiness, or taking laxatives to manage constipation.

Robert Jamison, a pain researcher at Brigham and Women’s Hospital, Boston, said the study’s results were not surprising and observed that patients and doctors are more aware of the dangers of opioid use given how widely the U.S. opioid addiction crisis has been reported.

“I’m sure that now with all the attention that opioids have been getting through the media, that anybody prescribing them is going to remind any user of the risks,” he told Reuters Health by phone.

SOURCE: bit.ly/2Yd7WnI American Journal of Emergency Medicine, online June 3, 2019.

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