Opioids, attention danger?
They work wonders when we suffer a lot
True. These formidable remedies, highly prized by doctors and patients, act quickly and efficiently. These are natural or synthetic substances, derived from opium, that activate the opioid receptors present in the body and thus block the message of pain. They are classified into two categories: "weak" opioids - codeine, opium powder and tramadol - and "strong" opioids - morphine, fentanyl and oxycodone. They are used to treat moderate to severe pain, such as those related to cancer or as a result of surgery or trauma.
We find them on sale
False. Since July 13, 2017, you can not get an opioid without going through the doctor box. Until that time, drugs containing low-dose codeine, such as Codoliprane, could be purchased without a prescription. To avoid this self-medication and the overconsumption that went hand in hand, the Ministry of Health said stop. A decision also motivated by the excesses observed in teenagers, who used syrups and tablets as a drug.
These are analgesics like the others
False. They are highly addictive. One can thus become addicted to tramadol, which is not the case with paracetamol and other analgesics. In addition to their analgesic effect, opioids have soothing, euphoric effects and reduce anxiety. As a result, even when the physical suffering calms down, the brain demands its dose to find peace. The profile of patients who become addicts despite themselves? People over 50, often women, with a history of anxiety, depressive or addiction disorders. A real risk of overdose and overdose by respiratory arrest exists. To win, the preferred solution is a step-by-step weaning and substitution treatment.
Doctors prescribe them too much
True. Between 2006 and 2017, the use of tramadol, the most consumed drug, for example, increased by 68%, while the use of oxycodone jumped 738%! So, yes, the management of the pain does not cease to improve, but that is not enough to justify this colossal increase. It is explained first by the withdrawal of Di-Antalvic and dextropropoxyphene-based drugs in 2011, which pushed patients to these alternatives. Above all, they are misrepresented, for example in the case of low back pain and migraines, where they are not indicated. Another misuse is that strong opioids, such as fentanyl, which should be reserved for cancer pain, are used for other pathologies.
They kill more than heroin
True. They are now the leading cause of death by overdose in France, with at least four deaths a week. Weak or strong, all opioids are dangerous. The most deadly is tramadol (37 deaths in 2016), followed by morphine (22 deaths) and codeine (16 deaths). In seventeen years, the annual number of poisonings has more than doubled and the number of hospitalizations has increased by 167% since 2000. Alarming figures, but much less than those recorded in the United States. With 115 deaths per day (60,000 in 2016), opioids make more victims than firearms. What to think before swallowing a tablet.
Thank you to Professor Nicolas Authier, Director of the French Observatory for Analgesic Drugs.
⋙ Pain: a new alternative to opioids
⋙ Codeine: the list of 70 drugs that will no longer be freely available
⋙ Chronic pain: opioids no better than ibuprofen