Powerful pain medicines that are either derived from opium or are chemically similar to opium. Most people are familiar with the use of opioids in treating pain related to cancer or surgery. However, many doctors feel they have an important role in treating arthritis pain as well.

In 2002, the American Pain Society published guidelines for treating arthritis pain. They recommended opioids for severe arthritis pain that is inadequately controlled with nonsteroidal anti-inflammatory drugs (NSAIDs) — or in cases where these drugs cause intolerable side effects. NSAIDs include traditional drugs such as ibuprofen (Motrin and others) and COX-2 inhibitors such as celecoxib (Celebrex). Some of the opioid products that have been used to treat arthritis pain include propoxyphene plus acetaminophen (Darvocet), hydrocodone plus acetaminophen (brand names Anexsia, Hydrocet, Lortab, Norco, and Vicodin), hydrocodone plus ibuprofen (Vicoprofen), codeine plus acetaminophen (Codrix, Tylenol with Codeine, and Tylenol No. 3), oxycodone plus acetaminophen (Percocet and Roxicet), oxycodone extended release (Oxycontin), morphine extended release (MS Contin), and fentanyl (Duragesic).

Some doctors and patients are concerned about opioids’ potential for becoming addictive, but addiction is actually quite rare when these drugs are used appropriately in people with no history of substance abuse. Some of the most common side effects of opioids are nausea, vomiting, constipation, drowsiness, and cognitive changes.

People taking opioids should avoid driving or operating heavy machinery until they know how the drug affects them. They should avoid drinking alcohol or taking other drugs that might affect mental function. Those taking controlled-release opioid products such as MS Contin or Oxycontin should never crush or chew the tablets, because this could cause rapid absorption and overdose.

Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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