Managing Side Effects of Narcotic Painkillers

If you suffer from chronic pain and over-the-counter drugs are not providing enough pain relief, you may ask your doctor to prescribe something stronger. The next drugs in line would be most likely be opioids (or narcotics) such as Vicodin, Dilaudid, OxyContin, Darvon, Percocet, Percodan, or probably the most well-known narcotic painkiller, morphine.

While these painkillers are increasingly being prescribed to patients for the treatment of multiple chronic painful conditions, they sometimes increase a patient's challenges. In other words, these painkillers are associated with a significant number of side effects, including addiction.

In a study review published in Pain Physician, researchers at the Millennium Pain Center in Bloomington, Illinois stated that abuse and diversion of opioids is a growing problem as the availability of these medications increases and the public health issue confounds their clinical utility. Additionally, the researchers pointed out that the extent of their efficacy in the treatment of pain when utilized on a chronic basis has not been definitively proven. Lastly, they stated that opioids are associated with a significant number of side effects and complications.

Common Side Effects of Opioid (Narcotic) Painkillers

These include:

  • Constipation
  • Nausea
  • Respiratory depression (slowed rate of breathing, one of the more serious concerns)
  • Vomiting
  • Drowsiness
  • Dizziness
  • Weakness
  • Dry mouth
  • Confusion
  • Difficulty urinating
  • Itching
  • Physical dependence (addiction)

Less Common Side Effects of Opioid (Narcotic) Painkillers

  • Delayed gastric emptying
  • Hyperalgesia
  • Immunologic and hormonal dysfunction
  • Muscle rigidity
  • Myoclonus

As one might guess, intolerable side effects from narcotic painkillers contribute to poor outcomes among patients.

Management of Side Effects

Evidence-based approaches to minimizing the side effects include:

  • Reducing the doses of opioids
  • Managing the adverse symptoms of opioids
  • Integrating opioid rotation
  • Changing the route of administration
  • Minimizing unnecessary medications

Managing these side effects, however, remains a clinical challenge. One issue is that some people get into a pattern where they are taking a lot of pills to manage their side effects and these counteract with the pills that they are already taking. The good news is that several clinical trials are underway to identify adjunct therapies that may mitigate these side effects.

Self-Care for Side Effects

The most common side effect of opioid usage is constipation. For constipation, self-care is possible. Make sure you drink enough fluids (most adults should drink between 8 and 10 glasses of water each day), and include fruits, vegetables, and fiber in your diet each day.

Other Treatment Options to Manage Pain

If you want to avoid narcotic painkillers altogether, other treatments have been proven to help manage pain including acupuncture, biofeedback, meditation, and even eating a balanced diet of fruits, vegetables, and whole grains. Keep in mind that when you exercise, your body produces opioids naturally, called endorphins. Try walking 30 minutes a day and see if this can provide you some pain relief.

If the side effects of narcotic painkillers are decreasing your quality of life, talk to you doctor immediately about other treatment options to manage pain.


Benyamin R., Trescot AM, et al. Opium Complications and Side Effects. Pain Physician. 2008 Mar;11(2 Suppl):S105-20. Accessed March 5, 2010.

Harris, J.D. Management of Expected and Unexpected Opiod-Related Side Effects. The Clinical Journal of Pain, 2008 May;24 Suppl 10:S8-S13. Accessed March 5, 2010.

O'Mahony S, Coyle N, Payne R. Current Management of Opiod-Related Side Effects. Oncology (Williston Park). 2001 Jan;15(1):61-73, 77; discussion 77-8, 80-2. Accessed March 5, 2010.

Swegle JM, Logemann C. Management of common opioid-induced adverse effects. Am Fam Physician. 2006 Oct 15;74(8):1347-54. Accessed March 5, 2010.

Tips for Managing the Side Effects of Narcotic Painkillers. May 30, 2008.,,20189463,00.html. Accessed March 5, 2010.