Codeine: Fact or fiction

Last modified: Thursday, 25. December 2008 - 10:30 am

Many commonly held assumptions about codeine and other opioid use need to be modified, according to a consensus statement issued by the American Academy of Pain Medicine and the American Pain Society.

Fiction — Opioids are always addictive. Patients who use them regularly will become drug addicts.

Fact — Studies show that very few chronic pain patients become addicted to their opioid pain relievers. What’s more, even known addicts can benefit from carefully supervised, judiciously prescribed opioids for treating pain due to serious medical conditions.

Fiction — Over time, chronic pain patients will develop a tolerance to opioids, making it necessary to continually increase the dosage.

Fact — Tolerance does not appear to be prevalent among long-term opioid users. In some cases, what appears to be a decrease in pain relief over time is actually a progression of the disease being treated.

Fiction — Opioids often cause prohibitive side effects, like depressed respiration, sedation, and nausea.

Fact — Respiratory depression tends to be shortlived and generally occurs only in patients who have just started taking a medication. Likewise, sedation and nausea usually decrease with continued use. (Adapted from Johns Hopkins Magazine, June 1999.)

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