Opiates
An opiate is a medication (or illegal drug) derived from the opium poppy. Opiate drugs are narcotic sedatives that depress activity of the central nervous system, reduce pain, and induce sleep (1). Technically, opiates only include those drugs that are directly derived from the opium poppy, such as morphine and codeine. The term "opioid" is a more general classification that includes opiates, as well as those drugs that mimic the effects of opiates, such as methadone. Often the terms are used interchangeably (2). Opioids are classified as narcotics, though not all narcotics are opioids.
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Opioids make highly effective painkillers, and for this reason they can be effectively integrated into
cancer care. However opioids can be addictive if not used for pain control and withdrawal
symptoms can be severe, and therefore
doctors are instructed to prescribe them with care (3). There is disagreement in the medical community regarding when to prescribe opiates; some suggest using mild opiates (such as codeine) for moderate pain and then converting to strong opiates (such as morphine) if pain persists or worsens, and others suggest the patient be given a strong, effective opiate from the start (2, 4).
Opiates may be taken by mouth, via injection, skin patch, rectal suppository, or intravenously, or through a patient's epidural catheter. Long-acting opiates, often delivered via skin patch or pill, can help cancer patients avoid the peaks and troughs common to many pain relief treatments (4).
Side-effects from opiates can include drowsiness, nausea, constipation and vomiting, though these can be minimized with other medications or therapies, and frequently decline in severity as use continues. Patients using opioids may gain a tolerance to the drugs, and require larger doses to control pain (4).