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Narcotic Analgesics

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By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: March 2024 | Last updated: March 2024

Narcotic analgesics are highly addictive painkillers. They are also known as narcotics, opiates, opioid analgesics, and opioids. An analgesic is a drug used to relieve pain. Narcotics may sometimes be used to treat migraine pain in people who do not get relief from other medicines.1,2

Because of the harm narcotics can cause, they are not prescribed as often as other drugs. Narcotics should not be the first therapy of choice for treating migraine. Narcotics or opioids are habit-forming. They can cause physical dependence as well as psychological addiction.1

If prescribed, narcotic drugs are only meant to be used for a short while or once in a while (intermittently). Long-term use can lead to tolerance, meaning that people need a higher dose to get the same effect. Overuse can also lead to more frequent or worse migraine attacks and opioid addiction.3,4

Narcotics and migraine

Narcotics are used to relieve pain. They bind to certain receptors in the brain to block pain. They do not treat the underlying cause of the pain. This is another reason why narcotics are not the best treatment for migraine-related pain.1

Using narcotics to deal with migraine pain might worsen migraines in the long term and cause other issues as well. One study compared people who use narcotics with people who use other ways to manage migraine pain. It showed that people who use narcotics:3,4

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  • Had more headaches
  • Were more likely to have anxiety and depression
  • Were more likely to develop other pain-related diseases like fibromyalgia

Examples

Examples of common narcotics that might be prescribed include:5

  • Oxycodone with acetaminophen (Percocet®)
  • Hydrocodone with acetaminophen (Vicodin®)
  • Codeine with acetaminophen (Tylenol-Codeine #3®)

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. Some of the side effects of using narcotics to manage pain include:6

  • Nausea
  • Itching
  • Drowsiness
  • Confusion
  • Slowed breathing
  • Constipation
  • Urinary retention

Narcotics have a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). They have this warning because narcotics are very addictive. This can lead people to abuse narcotics by taking more than the prescribed dosage. Overdose or taking too many narcotics can cause death.1

These are not all the possible side effects of narcotics. Talk to your doctor about what to expect when taking narcotics. You also should call your doctor if you have any changes that concern you when taking narcotics.

Alternatives to narcotics

There are other treatments available that are better first choices for acute migraine management. For example:5,7

  • Simple analgesics include over-the-counter pain relievers like acetaminophen.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of drugs that can relieve pain. Some of the NSAIDs, like ibuprofen, can treat migraine-related pain.
  • Triptans are a group of drugs that can treat headaches caused by migraine.
  • Neuromodulatory devices use electric currents or magnetic fields to send signals to parts of the brain involved in migraine-related pain.

All of these treatments have side effects. The best treatment for you will depend on the severity of your symptoms and any other conditions that you may have.7

Other things to know

You should not stop taking narcotics abruptly or all at once. Narcotics use should be tapered off, meaning you should slowly reduce the dosage that you are taking. This is especially true for people who take a high dose of narcotics. Stopping the use of narcotics suddenly can lead to serious side effects.1

Narcotics cause drowsiness. They should not be taken with alcohol or any other drug that causes sleepiness. Also, do not take narcotics if you will be doing any potentially dangerous activity. This includes:1

  • Driving
  • Operating heavy machinery
  • Working at heights

If you are taking narcotic analgesics, ask your doctor for naloxone. Naloxone is a medicine that can treat opioid overdose. Keep it with you as a precaution.1

Before beginning treatment for migraine, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

If you are already taking narcotics to deal with migraine pain, talk to your doctor about other treatments. Other treatments may work better at treating and preventing migraine pain.7