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If you’ve been dealing with vulvodynia for some time now you might have come across opioids as an available option to deal with your pain.
If you are in the early stages with your pain treatment program and need some additional help with pain management then opioids might be a temporary solution for you.
Also, a doctor might prescribe you this strong painkiller if you are unable to find a long-lasting remedy for your vulvodynia, while you are in the quest for a better solution.
#1: What Are Opioids?
Opioids are a class of drugs naturally found in the opium poppy plant, a type of flower. The first opioid medication, morphine, was created in 1803.
Prescription opioids are mostly used as a very strong pain medication to treat acute and chronic pain of moderate to severe intensity. Some opioids, however, can be used to treat coughing and suppress diarrhea.
In addition, opioids can make some people feel relaxed, happy or “high,” and because of it, they can be highly addictive.
#2: How Do Opioids Work?
Inside our bodies, we own personal “natural opioids” called endorphins. They are able to eliminate minor pain like the one after hitting an elbow, but not strong, acute pain like a broken bone or surgery.
Opioids impersonate the effects of endorphins by mimicking their chemical structure. They suppress pain messages from traveling along nerves.
#3: Opioids for Vulvodynia
Opioids are used in short and long-term when treating chronic vulvar pain.
Short-term usage
In short-term cases, opioids for vulvodynia are usually used at the beginning of early treatments, when other medications (like anticonvulsants or antidepressants) are gradually increased to a therapeutic level.
Long-term usage
In severe, long-term cases, when other non-narcotic therapies fail when treating vulvodynia, opioids might be used on an ongoing basis.
IMPORTANT: Please remember opioids aren’t really meant for long-term use, as they are highly addictive, and prolonged usage of opioids is linked surprisingly with the worsening of chronic pain.
It is believed that after extended usage, the brain counters the effects of the drug, increasing the pain sensation. Another explanation is that individuals can develop tolerance to the drug, which leads to administering increased and stronger dosages.
#4: Types of Opioids for Vulvodynia
The two most used prescription opioids for vulvodynia are:
- Hydrocodone (Vicodin, Hycodan)
- Oxycodone (OxyContin, Roxicodone, Oxecta, Percocet)
#5: Opioids Dosage
Different types of opioids are prescribed in different strengths and dosages, and administered in various forms, taken by yourself or given by health professionals, depending on various factors such as:
#6: Best Practices for Opioids Uses
#7: Opioids Side Effects
The most common opioid side effects
- Constipation
- Dizziness, drowsiness, and sedation
- Nausea and vomiting
- Itchiness
- Dry mouth
More serious side effects
- Respiratory depression such as slowed breathing which might cause hypoxia (a condition when too little oxygen reaches the brain)
- Lower heart rate and blood pressure
- Thought and memory problems
- Confusion
- Anxiety
- Euphoria
- Cognitive effects
- Loss of consciousness
- Impaired sexual function and decreased sex drive
- Depression
- Irregular menstruation
- Increased risk of falling
- Immunodeficiency
- Increased pain sensitivity
- Coma
- Numbness
- Hormonal problems and changes of infertility (link to long-term use)
- Death (in case of overdosing)
- Hallucinations
- Headaches
- Urinary retention
#8: Opioids Interactions
IMPORTANT: Please inform your doctor about anything else you take while taking opioids, including all prescription and non-prescription medications, and illegal, recreational, herbal, nutritional, or dietary drugs. By taking different meds simultaneously you can intensify the side effects.
Among the drugs that may interact with opioids are:
- Alcohol
- Some antidepressants such as benzodiazepines
- They can cause respiratory depression
- Antihistamines such as diphenhydramine
- Benzodiazepines (such as Xanax or Valium)
- Muscle relaxants such as Soma or cyclobenzaprine (Flexeril and Amrix)
- They can slow the breathing causing hypoxia, a condition characterized by too little oxygen reaching the brain.
- Anti-seizure medications, such as carbamazepine (Carbatrol and Tegretol)
- Certain antibiotics including clarithromycin (Biaxin)
- Certain antifungals including itraconazole (Onmel, Sporanox), ketoconazole and voriconazole (Vfend)
- Certain antiretroviral drugs used for HIV infection, including atazanavir (Reyataz), indinavir (Crixivan), ritonavir (Norvir) and others
- Drugs for sleeping problems, such as zolpidem (Ambien, Intermezzo, Lunesta)
- Drugs used to treat psychiatric disorders, such as haloperidol (Haldol)
- Other opioid medications
- Sedatives, such as diazepam (Valium)
#9: Opioids Contraindications and Warnings
1. If you are pregnant (or planning to get pregnant):
If you are pregnant and use prescription opioids, this can lead to miscarriage.
Also, your baby can have a low birth weight, develop dependencies and have withdrawal symptoms after birth. This is called neonatal abstinence syndrome and can be treated with medication.
Also quitting opioids abruptly can cause rapid and severe withdrawal which is associated with premature labor and spontaneous abortion.
Neonatal abstinence syndrome signs include:
- High-pitched cry, irritability
- Disturbance of sleep-wake rhythm
- Muscle tone and movement disorders
- Seizures
- Poor feeding, vomiting, diarrhea
- Failure to thrive
- Breathing problems such as tachypnea, apnea, sneezing
- Fever and sweating
- Heart problems such as hypertension, tachycardia
2. If you are breastfeeding:
Some opioids can pass into breast milk causing side effects in a breastfed child such as constipation, sedation, changes in feeding patterns, respiratory depression and in some cases withdrawal effects.
Please talk to your doctor about the possible risks to you and your baby, in order to weigh these risks against the benefits of using opioids.
3. If you have gastrointestinal problems:
If you suffer from paralytic ileus, or IBS (inflammatory bowel syndrome) you might be unable to take opioids, as they can aggravate bowel symptoms and increase pain rather than soothing it.
Opioids can damage the delicate lining of the gastrointestinal tract and change its microbiome. They can throw off the balance of bacteria in the gut stimulating bad bacteria overgrowth. This can contribute to an inflammatory response from the immune system.
4. If you have lungs problems:
The drug affects breathing and can cause respiratory depression such as hypoxia (a condition characterized by too little oxygen reaching the brain). This condition can cause short and long-term psychological and neurological effects including coma, permanent brain damage or death.
To avoid this potential risk, you might not be able to take opioids if you suffer from any lung diseases such as acute or severe bronchial asthma, chronic bronchitis, and emphysema.
5. If you suffer from seizures:
Some opioids have the potential to lower the seizure threshold and should be cautiously avoided if you have a history of seizure disorder in order to avoid causing or worsening seizures.
6. If you have kidney and liver problems:
Your body removes opioids through your kidneys and liver. Renal (kidney) and hepatic (liver) diseases can result in significant alterations in the way your body handles the drug.
7. Opioids have high risk of tolerance, dependency and addiction:
Opioids are generally safe when you take them for a short time and as prescribed by your doctor.
However, by extending usage, you can develop tolerance, dependency, and addiction to the drug.
Tolerance: Opioid tolerance happens when your body needs higher and more frequent doses of the drug to achieve the same desired pain effects.
Dependency: Opioid dependency happens with the repeated use of the drug over an extended period of time. This causes your nervous system to adapt to the medication so that it functions normally in the presence of the drug. The absence of the drug causes withdrawal symptoms.
Addiction: Opioid addiction is a chronic disease characterized by compulsive or uncontrollable drug seeking and usage despite harmful consequences and long-lasting changes in the brain.
Opioid painkillers are highly addictive. After just 5 days of prescription opioid use, the chances of developing an addiction increases.
Mental health and substance abuse problems that increase your risk of opioid abuse and addiction include:
- History of severe depression or anxiety
- Heavy tobacco use and using other substances that lead to dependence
- Prior drug or alcohol rehabilitation
- A family or personal history of substance abuse
- Multiple psychosocial stressors
- Young age
- History of childhood abuse
8. Overdose of opioids can be fatal:
Opioids influence your breathing and heart rate by slowing it down, in an overdose situation till your breath and heart stop.
Some signs of an overdose include:
- Very small pupils that don’t change size when light is quickly shone in your eyes
- Losing consciousness or going into a deep sleep from which you can’t be wakened
- Very slow breathing
- Fingernails or lips that appear purple or blue
#10: Opioids Discontinuation
Opioids can produce strong withdrawal symptoms if you stop them suddenly. To avoid them you need to slowly taper off. The duration of tapering can range from a few days, weeks to several months.
The First Withdrawal Phase
If you stop opioids suddenly, the first phase, the acute withdrawal, which has mostly physical symptoms, begins about 12 hours after your last dose. It peaks at around 3-5 days and lasts for approximately 1-4 weeks.
The Second Withdrawal Phase
The second phase, the post-acute withdrawal, which has mostly emotional symptoms, can last up to two years. It is less severe but lasts longer.
The effects are uncomfortable but not life-threatening and may include:
- Jittery nerves
- Insomnia
- Muscle and bone pain and aches
- Sleep problems
- Nausea, diarrhea, and vomiting
- Cold and hot flashes with goosebumps
- Uncontrollable leg movements
- Severe cravings
- Drug cravings
- Anxiety, irritability, and agitation
- Mood swings
- Low energy and enthusiasm
- Abdominal pain and cramping
- Tremors (shaking)
- Runny nose, teary eyes
- Yawning
- Restlessness
- Involuntary leg movements
- Problems with concentration
Conclusion
In this post, you can find general information about opioids for vulvodynia:
- What opioids are and how they work
- How and which opioids can help with vulvodynia
- Information regarding dosage
- What types of side effects you might experience, including withdrawal symptoms
- Possible interactions, contraindications, and warnings
Please don’t feel discouraged if your pain will come back after the discontinuation of opioids.
Please keep in mind that opioids like other types of traditional medications might not treat nor heal the underlying root cause of your vulvar pain. Rather than temporarily eliminating evidence of the illness or masking the symptoms. Opioids also don’t heal your body.
Please remember that opioids are definitely not the only solution available for vulvodynia. There are still other medical and natural remedies that you can explore.
Did you find this post helpful? What other types of information would you like me to share with you?
Have you ever taken opioids? If yes which ones? Did and how opioids help your symptoms?
Share with me all of your thoughts, experiences, and questions in the comments below! You can also ask me anything directly on FB.
Disclaimer
My goal is to provide you with the most relevant and current information that is factually correct, comprehensive and up-to-date.
However, the drug information provided herein is subject to changes and is not intended to cover all possible:
- Uses
- Dosage indications and best practices for usage
- Side effects
- Drug interactions
- Contraindications and warnings
- Drug withdrawal symptoms
Additionally, each person is different and may respond differently to the drug.
Please also bear in mind, that this article should not be used as a substitute for the knowledge and expertise of a doctor or other licensed healthcare professionals. Please, before taking any medication, consult with a health provider who knows your medical history.
Resources
- https://en.wikipedia.org/wiki/Opioid
- https://www.drugabuse.gov/drugs-abuse/opioids#summary-of-the-issue
- https://www.drugabuse.gov/publications/drugfacts/prescription-opioids
- https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/expert-answers/what-are-opioids/faq-20381270
- https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-use-opioids-safely/art-20360373
- https://www.hopkinsmedicine.org/opioids/what-are-opioids.html
- https://www.asahq.org/whensecondscount/pain-management/opioid-treatment/what-are-opioids/
- https://www.webmd.com/pain-management/opioids-opiates-explained#2
- https://www.sciencenewsforstudents.org/article/explainer-what-are-opioids
- https://www.webmd.com/pain-management/guide/narcotic-pain-medications#3
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4887963/
- https://www.womenscollegehospital.ca/assets/pdf/TAPMI/PrimaryCareOpioidHandbookforChronicPain.pdf
- https://www.everydayhealth.com/crohns-disease/symptoms/new-study-finds-opioids-can-worsen-ibd-pain/
- https://intermountainhealthcare.org/ext/Dcmnt?ncid=520732125
- http://www.health.utah.gov/prescription/pdf/guidelines/absolute_contraindications.pdf
- https://www.healthline.com/health/opioids-list
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