Wednesday, January 25, 2023

Why Do Opiods Cause Constipation

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Drug Treatment For Opioid

How do opioid medicines cause constipation?

Prevention of opioid-induced constipation is always preferred over treatment. Exercise, added fiber in the diet with whole grains, fruits and leafy vegetables, and plenty of fluids can be helpful, but may not work for everyone. In these cases, typical first-line agents used in OIC include:

  • Docusate
  • Daily use of a common surfactant stool softener available over-the-counter . As noted above, docusate is probably best combined with senna for treatment or prevention of OIC in patients with hard, dry stools. Used by itself, docusate is often not effective.
  • The Dangers Of Hydrocodone Abuse

    When someone takes hydrocodone for an extended period of time, they will likely develop a tolerance to it. The body adapts to the substance and requires the person to take a higher dose for the same effect. This can lead to physical dependence, a state in which someone must take hydrocodone in order for their body to operate normally.

    Physical dependence is often accompanied by addiction, a mental craving for the drug that results in drug-seeking behaviors and compulsive use despite negative physical and social consequences.

    Often, someone who becomes addicted to hydrocodone begins taking it as prescribed by their doctor. Over time, they take more and continue to take it longer than recommended. Because snorting hydrocodone takes it to the brain more quickly, they may begin to abuse it in this way, especially if they have built a tolerance to it.

    Many states monitor controlled substances, making it more difficult for people to go doctor shopping and obtain multiple prescriptions. This may prevent some people from abusing prescription opioids, but those suffering from addiction may obtain hydrocodone on the street.

    Sadly, some people who begin abusing prescription opioids eventually turn to heroin. Also an opioid, heroin has many of the same effects as hydrocodone, but it comes at a lower cost. It may also be more dangerous, as it is frequently laced with impurities and other substances like fentanyl, which can be deadly even in small doses.

    Opioids And Constipation: It Happens

    You probably already know that opioid use is accompanied by many side effects like sedation, nausea, and tolerance. An opioid is sometimes called a narcotic, and they are used for varying degrees of pain.

    But what you may not know is that one of the most common and troubling side effects with opioids is opioid-induced constipation. In fact, 40% to 80% of patients taking opioids over the long-term may suffer from this side effect.

    Talking about constipation can be embarrassing, but it can be a serious side effect and deserves your attention. Opioid-induced constipation can occur among patients with chronic non-cancer pain, such as:

    • musculoskeletal pain like severe back pain
    • osteoarthritic knee pain
    • other degenerative joint pain

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    Why Do People Snort Hydrocodone

    When taken orally, hydrocodone travels through the body before entering the bloodstream and affecting the brain. When someone snorts hydrocodone, blood vessels in their nose absorb it, producing a quicker and more intense high.

    Though smoking and intravenous injection both take a substance to the brain faster than insufflation, these are not common methods of taking hydrocodone and have a reputation of being more dangerous. Snorting a drug is no safer than smoking or injection, but many people believe that it is.

    Treatment For Hydrocodone Addiction

    Why Do Opioids Cause Constipation?

    A person struggling with hydrocodone addiction does not have to be alone. There are many inpatient treatment programs for opioid use disorder that immerse the individual in a community of love and support. Getting away from everyday life is often the first step toward recovery.

    Treatment programs in inpatient drug rehab centers may be tailored to the individual. Many take a holistic approach, aiming to heal a persons mind, body and spirit. The best programs go beyond treating the addiction and also address underlying issues that may contribute to substance misuse.

    Some treatment plans include medication-assisted treatment for opioid addiction, which combines medication with various treatment methods such as behavioral therapy, counseling, and support groups. Other important aspects of treatment may be learning life skills, exercising coping techniques and rebuilding family relationships.

    To learn more about the dangers of snorting hydrocodone and to explore treatment options, contact us today.

    This page does not provide medical advice.

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    Deterrence And Patient Education

    Lifestyle Changes

    Whenever an opiate is prescribed, the patient should be educated on the prevention of constipation. This means eating an adequate fiber in the diet, drinking ample water, exercising to encourage motility of the bowels, limiting intake of other painkillers, and using a laxative. Other alternatives instead of milk of magnesia include the use of docusate or polyethylene glycol. The changes in lifestyle should start at the same time as the opioid therapy and continue for the duration of treatment.


    There are many fiber-rich foods that one can eat to treat constipation. Fruits like apples, bananas, prunes, pears, raspberries, and vegetables like string beans, broccoli, spinach, kale, squash, lentils, peas, and beans are often recommended. One can also eat almost any type of bran products and nuts. When eating foods with fiber, it is important not to consume more than 25 to 30 grams per day otherwise it can lead to a bloating sensation.

    Opioid Addiction And Abuse

    Perhaps the most dangerous side effect of opioids linked to prolonged use is addiction. Since they produce pleasurable and euphoric effects, they are highly addictive and thus, chronic consumption of this substance especially in the form of drugs can lead to abuse and addiction. This is a grave issue, which can cause severe physical and mental problems.

    If some signs of abuse are noticed in a patient, they should immediately seek resources such as addiction treatment for opioids. This condition brings severe risks because the user becomes highly dependent on the drug and loses control of the senses and body when opioid tolerance and withdrawal occurs. Addiction can end up lethal. According to opioid crisis statistics, around 72000 people died in the US in 2017 due to opioid addiction.

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    Opioids And Pregnancy: Taking Opioids While Pregnant

    According to the Centers for Disease and Control Prevention, seeing the harmful side effects of painkillers, pregnant, and breastfeeding women are advised not to take any medicines without consulting a doctor. During pregnancy, a womans body undergoes massive hormonal changes, and it is likely to react to medication differently than under normal circumstances. Thus, it can be said that pregnant and breastfeeding women are at a higher risk of suffering from the dangerous adverse effects of opioids.

    The use of painkillers, such as Oxycodone, Hydrocodone, Codeine, Hydromorphone, and Fentanyl, must be strictly avoided during pregnancy. These drugs are categorized as Pregnancy Category C where studies have found significant adverse effects on the fetus. Furthermore, these pills are also highly addictive and prolonged use of opioids in pregnancy can lead to addiction. Pregnant women with this disorder are most at increased risk of serious complications, including placental abruption, abnormal fetal growth, premature birth, and stillbirth in extreme cases.

    When You Try To Move Your Bowels While On Opiates

    Understanding Opioid-Induced Constipation
    • The feces are hard, dry and painful. This is because the longer it takes for the stool to pass through your large intestine, or colon, the more water your body absorbs from them
    • You have to strain at stool
    • Even when you do have a bowel movement, it feels incomplete. There is actually a word for this: tenesmus

    When opiates cause constipation, it can occur at any time. It also doesnt go away over time like other side effects, because you GI tract doesnt adapt to the drug the way the rest of your body does. Indeed, the longer you take the drug, the worse your constipation gets. Moreover, the usual remedies that help normal constipation do not work well when you are constipated from opioid use.

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    The Interactions Of Opioids And Depressants

    Depressants are prescribed for insomnia, anxiety, hypertension, and seizures. They include sedatives , barbiturates , and tranquilizers . Opioids belong to a highly addictive set of drugs that can cause dependence and tolerance with prolonged use. When individuals develop a tolerance to them, they may take other substances to enhance the effect. However, when combined with depressants, the risk of overdose dramatically increases. The typical opioid addiction signs and symptoms worsen when it is combined with depressants. Risks associated with this kind of drug mixing include breathing problems, confusion, unconsciousness, and coma.

    Medication Related Cardiac Problems

    Cardiac problems associated with opioid use are rare. Although no direct link between opioid usage and chronic heart failure has been established, there are many severe cardiac problems linked to the long-term side effects of opioids, including impaired functioning of the heart muscle, slower heart rate, and dilation of blood vessels. Apart from these, ventricular tachycardia, a type of cardiac arrhythmia, atrial fibrillation, and infectious endocarditis are also fairly common heart side effects associated with prolonged use.

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    Medications That Cause Constipation

    You have heartburn and an acid taste in your mouth. You know that you are having acid reflux. You bought an antacid liquid and started using it. After a few days, you got constipation. Wonder why?

    The reason is, some medications can cause constipation. It is a common side effect of many over the counter as well as prescription medications. Here is a list of medications that can make you constipated.

  • Aluminium containing antacids. These medications are used to treat acid reflux and stomach ulcers .
  • Calcium supplements such as calcium carbonate, calcium citrate, and calcium phosphate.
  • Iron supplements such as ferrous sulphate, ferrous fumerate and ferrous gluconate
  • Blood pressure medications: Calcium channel blockers such as Nifedipine, Diltiazem
  • Aspirin
  • Antidepressant medications such as Amitriptyline, Zoloft, and Effexor
  • Opioid painkillers. This class of drugs may cause severe constipation that may not respond to simple remedies. Examples: Codeine, Morphine sulphate, Oxycodone, Methadone, Tramadol, Fentanyl. These analgesics are usually given after surgery to relieve severe pain.
  • Over the counter cough medicines. Some OTC cough medicines contain codeine or hydrocodone that can make you constipated.
  • Cholesterol lowering agents, such as Cholestyramine, Statins
  • Nonsteroidal anti-inflammatory drugs such as Ibuprofen. These pills are often given to patients with arthritis or back pain.
  • Drugs used to treat abdominal pain, such as Hyoscine Butylbromide
  • Bottom line:

    Are There Diagnostic Tests That Confirm Opioid

    Slide Show

    Specific tests are not the main way to diagnose OIC. Constipation is very common when you take opioid medicines. So, if you start taking them, start taking a different one, or increase your dose and become constipated, it is very likely opioids are the cause. However, your healthcare provider may request an X-ray to see if waste has built up in your body, and if so, how much. If your healthcare provider is concerned you may have a digestive problem besides constipation, then they might perform a colonoscopy which is an examination of your digestive system with a thin, lighted tube inserted into the rectum.

    Learn more about GI Motility Tests

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    Home Remedies For Opioid Induced Constipation

    It is possible to take certain steps and use home remedies to prevent and treat opioid induced constipation. Here are some suggestions.

    1. Mind Your Diet

    Your diet will have a huge impact on your health, and what you eat will also affect the health of your gastrointestinal tract. Here are some steps to take:

    2. Do Exercises

    Only changing your diet may be not enough, you’d better make an effort to have a healthier lifestyle. You should exercise regularly to improve your digestive health. Regular exercise helps increase blood circulation that in turn stimulates the bowel muscles and ensures proper movement of stool through the colon. Try yoga and stretching to help make your bowel muscles more pliable. Staying active will also help reduce the need for opioid analgesics because regular exercise may help reduce chronic pain. You can try water exercises or simply walk on a treadmill.

    Which Bowel Diseases Can Cause Constipation

    Bowel diseases that can cause constipation include irritable bowel syndrome , bowel obstruction , or cancer. Other non-gastrointestinal conditions that can cause constipation include low thyroid hormone levels, diabetes, Parkinsons disease, multiple sclerosis and more. You could also have dyssynergic defecation, which is difficulty coordinating your muscles when having a bowel movement. Your healthcare provider will check for these and other conditions if necessary.

    Your healthcare provider will check for other symptoms of these diseases when they examine and talk to you. They might ask you to see a specialist to learn more. If you do not have a specific disease, opioids are very likely to be the cause of your constipation.

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    Which Drugs Cause Opioid

    Any drug that is classified as an “opioid” can cause constipation. Examples of commonly prescribed opioids that may cause this side effect include:

    While many opioid side effects such as drowsiness, nausea and vomiting, and respiratory depression may lessen over time due to the development of tolerance, the constipating effects of opioids can last throughout the entire period of treatment.

    Guidelines state opioids should not be used first-line as treatment for chronic, non-cancer pain, but opioid-induced constipation can happen quickly — in a matter of days. This can result in more serious complications, like fecal impaction, anal fissures, rectal bleeding or prolapse, stomach pain, hemorrhoids, or perforation. It’s nothing to laugh about, and it is important you bring up constipatin concerns with your doctor.

    Dietary And Lifestyle Changes

    How is opioid-induced constipation (OIC) diagnosed?

    Adjustments in dietary and lifestyle habits can effect notable improvements in OIC or constipation from any cause. To help improve constipation, current guidelines recommend daily ingestion of 25 to 30 g of dietary soluble fiber adequate fluid ingestion regular aerobic exercise balanced diet regular meal pattern and avoidance of heavy meals, fat, insoluble fiber, and flatulent foods.7 Although these measures should be recommended to patients during pharmacy consultation for opioid initiation, it is unlikely that dietary and lifestyle changes alone will prevent or treat OIC.4

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    Pharmacological Prevention And Treatment Of Oic/oibd

    The Choice of a Laxative to Treat OIC/OIBD Depends on the Perceived Efficacy and the Preference of the Patient Indirect Evidence Favors Bisacodyl, Sodium Picosulfate, Macrogol , and Sennosides as First Choice

    When the choice of the rescue laxative was decided by OIC patients, in one study approximately 8090% of patients preferred a stimulant laxative , whereas in another study macrogol and sodium picosulfate were the preferred laxatives . Hence, bisacodyl, sodium picosulfate, sennosides, and macrogol appear to have similar efficacy in OIC .

    Preventive administration of laxatives to 720 adult Japanese patients treated with oral opioid analgesics for the first time was effective in preventing OIC . The most frequently prescribed laxatives were magnesium oxide and senna. There were no apparent differences in the efficacy between laxatives .

    Of importance is that many patients are not informed about constipation and laxatives when opioids are prescribed. Hence, in a recent interview study at the pharmacy with patients having their first opioid prescription, only 28% remembered having received information about the risk of constipation and 13% were prescribed laxatives or instructed to request them .

    Sugars and Sugar Alcohols Such as Lactulose, Lactose, and Sorbitol Should Not Be Used to Prevent or Treat OIC

    Gastro-Oesophageal Reflux Symptoms as Part of OIBD Should Be Treated like Primary Reflux Disease

    Opioids And Hallucinogens Interactions

    Hallucinogens are psychoactive agents which cause distortions in ones perceptions, hallucinations, and changes in thoughts and consciousness. Combining opioids and hallucinogens can result in increased severity of adverse effects such as CNS depression which may require immediate medical care and attention. Some of the hallucinogenic drugs include shrooms, DMT, and LSD.

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    Opioid Interactions With Other Substances

    Individuals on pain-relieving treatment often mix it with other substances such as alcohol and marijuana to enhance the effect. This kind of mixing often results in undesirable and serious effects such as the increased risk of CNS depression, which can even prove to be fatal. It is recommended to seek resources such as addiction treatment for opioids if such behavior patterns were noticed.

    Opioids and Alcohol

    Mixing alcohol and opioid drugs can cause Serotonin Syndrome. This syndrome is characterized by an increase in the amount of serotonin in the body and causes confusion, increased heart rate, and agitation. This mix can also lead to severe effects such as seizures and tachycardia. Other effects of opioids and alcohol interaction include profound sedation, respiratory depression, coma, and death.

    Opioids and Marijuana and CBD

    has been used for medicinal purposes for many years as an effective pain reliever. Similarly, CBD has also been legalized in many states to be used for pain relief. According to a clinical trial of medical doctors from the United States, Marijuana and opioids as well as CBD and opioids, when combined, may enhance pain relief properties but only when used in controlled doses for the short term. In the same study, it was reported that patients who use these opioid drugs and CBD properly under the care and intervention of a medical doctor may experience improved quality of life.

    What Should I Ask My Healthcare Provider About Diagnosing Opioid


    Make sure your healthcare provider knows about all the medicines you currently take, ask them which ones may cause constipation, and how they can determine if a particular medicine is the cause of your constipation. You can also ask if they are concerned about other conditions and if you need specific tests to learn why you have constipation.

    Talking with your healthcare provider about your concerns is the best way to stay healthy and comfortable while getting the symptom relief you need.

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    Opioids Interactions: What Are The Dangers And Adverse Reactions

    Opioids are known to interact with dozens of other drugs and substances. Drug tests often show that patients are mixing them with other medications to elevate the drug effect, but instead, it results in various adverse reactions much more often. For example, opioids and benzodiazepines are two different kinds of medication that can cause severe interactions when taken together. They can cause opioid overdose symptoms and severe side effects which can even be fatal.

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