Opium Based Drugs for Neuropathy

Following on from yesterday's post about opioids in general, todays list of opioids commonly prescribed for neuropathic pain, comes from Livestrong.com (see link below). It gives a brief description of how each opioid-type works and where it comes from and is a useful reference to back up any decision you might make about beginning opioid treatment.

Opium Based Drugs for Diabetic Neuropathy
Jul 1, 2010 | By Stephanie Chandler

Neuropathy describes a group of conditions caused by nerve damage resulting in chronic pain. Diabetes, a disease involving increased levels of glucose--sugar--in the blood, causes neuropathy in 60 to 70 percent of patients, according to the National Diabetes Information Clearinghouse. The most common type of neuropathy, peripheral neuropathy, affects the nerves outside the central nervous system, causing pain, numbness and tingling in the arms, legs, hands and feet. Doctors prescribe opium based drugs to relieve the pain of diabetic neuropathy.

Morphine
Morphine, the most abundant natural substance in the opium plant, provides the standard by which doctors measure all other opiate drugs. Morphine effectively binds to the opiate receptors in the brain, altering the transmission and perception of pain signals. Morphine relieves severe pain but also induces side effects including respiratory depression, sedation, nausea, vomiting and constipation. Morphine also triggers tolerance--the need for additional medication to gain the same effects, and addiction.
Doctors often prescribe morphine to treat diabetic neuropathy; however, the incidence of side effects limits the dose which limits the effectiveness often only reducing the pain by only 26 to 38 percent, according to a study published in the March 31, 2005, issue of the "New England Journal of Medicine." This study found that combining the opium-based morphine with the anti-seizure medicine gabapentin provides better pain relief with fewer side effects.

Oxycodone
Oxycodone, classified as a semi-synthetic opiate drug, is derived from the substance of the opium plant known as thebaine. Oxycodone produces similar analgesic effects to morphine, making it useful to treat moderate to severe pain such as that caused by neuropathy. Extended release, or controlled release, formulations of oxycodone slowly release the drug controlling the neuropathic pain continuously. Similar to morphine, oxycodone causes sedation and can lead to tolerance and addiction.

Tramadol
Opium based drugs produced in a laboratory to be chemically similar to natural substance in opium, such as morphine or codeine, are known as synthetic opiates. Tramadol, a synthetic opiate, resembles codeine and treats moderate to moderately-severe pain, according to MayoClinic.com. The controlled-release formulation can treat chronic pain such as neuropathic pain. Side effects include dizziness, sedation, nausea, vomiting and constipation.

Fentanyl
Fentanyl, another synthetic opiate, is one of the most potent opium-based pain relievers. The Drug Enforcement Administration reports fentanyl as 100 times more potent than morphine. Available as a transdermal patch that slowly releases medication through the skin, doctors often prescribe fentanyl to treat chronic conditions including diabetic neuropathy. Fentanyl causes side effects including sedation, respiratory depression, nausea and vomiting but unlike other opium-based medications produces minimal effects on the heart.

http://www.livestrong.com/article/161421-opium-based-drugs-for-diabetic-neuropathy/