Morphine is reserved for cancer pain
FALSE
Chronic pain cancer related are an important indication for opium drugs (drugs derived from opium). But they are also widely prescribed in acute pain of short duration: after surgery, during a major trauma or in the event of a renal colic, of acute low back pain associated or not with sciatica, or during a myocardial infarction… They can also be prescribed in chronic pain, mainly rheumatic. “However, in pain not related to cancer, opioids should be used after an evaluation carried out in a multidisciplinary pain center “, insists Dr Pierre Tajfel, pain doctor in palliative care, in Versailles (78).
It makes you dependent
RIGHT WRONG
Of course, there is a risk. But, well prescribed for the right pain to the right person, opioids are not addictive. “When you break a leg, you need crutches. It’s an addiction … But, when you’re healed, you let them go. It’s the same with drugs “, explains Professor Serge Perrot, head of the pain department at Cochin hospital (Paris). Long-term prescriptions for non-cancerous pain, however, require regular reassessment.
Morphine can cause side effects
TRUE
“All people on opioids are constipated when the treatment lasts a few days”, underlines Prof. Alain Eschalier, director of the INSERM Neuro-dol unit in Clermont-Ferrand (63). Nausea and vomiting can also be observed. “The prevention of these side effects must be ensured by taking laxatives and antiemetics (against vomiting), without waiting for their occurrence”, says Dr Tajfel.
Some patients will also feel drowsy. This occurs especially in the titration phase, that is to say the period during which the doses are gradually increased in order to find the one which has the best efficacy / tolerance ratio. Persistence or reappearance of drowsiness beyond a few days may be an early sign of overdose. It is then necessary to adapt the treatment. There are other side effects, such as breathing problems. They are known, which makes it possible to prevent them.
It comes in different forms
TRUE
Most often, opioids are prescribed in city medicine in the form of capsules or tablets. There are prolonged-release forms: their action is effective and lasts approximately 12 hours, ie one intake in the morning and one in the evening, without waiting for the onset of pain. The transdermal patch has a duration of action of 72 hours.
The doctor may also prescribe morphine with immediate effect, the action of which is limited to 4 hours. It is the patient who decides to take it if necessary. There are nasal or sublingual (under the tongue) forms that work even faster. After an operation or in cancer patients, it is also possible to inject yourself with an opioid, using a portable electronic pump. The device is preset in order to avoid any overdose.
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