The search for different ways to treat pain has been a constant throughout history, opioid painkillers have been used naturally for a long time, obtained from the opium factory.
In 1806 morphine was first ingsed as the main component of opium, and subsequently the development of this group of drugs began.
- What are opioid painkillers? These are drugs with strong analgesic power that owe their pharmacological action to binding with the opioid receptors of the central nervous system.
- There are natural opiates derived from opium.
- Such as morphine.
- And other synthetic products.
- Such as fentanyl.
They are characterized by having a homeless analgesic power. That is, at more doses, greater analgesic effect. However, this also comes with many side effects as we’ll see later.
They are mainly used in the treatment of severe and acute pain, as well as in terminal patients, especially those with cancer.
Before starting treatment with opioid painkillers, an appropriate evaluation should be performed. They should be used to treat severe pain that other types of medications are not helpful.
Opioid painkillers, as we said, join the opioid receptors in the central nervous system.
Although there are mainly 4 types of receptors, only 3 of them act on pain:?,?And? (mu, kappa and delta). Depending on the affinity with the receptor and the action they exert on the receptor, opioid drugs have different effects.
Based on their affinity with receptors and their clinical utility, we categorize them as follows:
In addition to being useful in analgesic pain treatment, opiates are also used in other areas, such as anesthesia, in these cases they are often used in combination with an anesthetic drug and a neuromuscular blocker.
They can also be used to sleep a patient or to suppress autonomous breathing in case of need of mechanical ventilation.
The main problem with using these opioid painkillers is the risk of addiction, so they are usually only used for short-term treatments of acute pain or in terminal patients.
The most common side effects of treatment with these medications are
Other side effects that may also occur include:
Chronic use of opioid painkillers has also been observed to have a depressant effect on the immune system. Therefore, it reduces its ability to produce antibodies and increases the chance of developing infections. Other possible cardiovascular effects include bradycardia and hypotension.
When long-term treatment with opioid painkillers usually appears tolerance, i. e. more and more doses are needed to achieve the same therapeutic effect, it can be said that the body gets used to the drug.
They can also lead to physical dependence, leading to withdrawal syndrome by stopping treatment or a significant reduction in dose, which can be avoided if the reduction is gradual, following the specialist’s instructions.
Another type of addiction would be psychological, also called addiction, in this case the patient looks for the psychic effects of this type of medication, above the goal of analgesia and pain treatment.