Narcotic Analgesics

Reviewed by: HU Medical Review Board | Reviewed April 2022 | Last updated: August 2022

Narcotic migraine medicines, also referred to as opioid analgesics, are naturally occurring or synthetically made derivatives of compounds in opium poppies. These substances are known as narcotics, opiates, and opioids. Narcotics are prescription medicines that can be powerful pain killers.

Opioid medications, especially codeine, are sometimes used to treat migraine pain for people who can't take or don’t get relief from other medications.1

Narcotics or opioids are habit-forming and should be taken with caution. They commonly cause physical dependence or psychological addiction. For this reason, these drugs are only meant to be used intermittently (off and on) or for the short term. Long-term use can lead to tolerance, meaning that patients need a higher dose to get the same effect. Overuse can also lead to rebound headaches and opioid addiction.2

What are some common narcotic analgesics?

  • Codeine, which is often combined with acetaminophen in Tylenol-Codeine #3 and #4
  • Hydrocodone, often combined with acetaminophen in Lortab® and Vicodin®
  • Meperidine, under the brand name Demerol®
  • Oxycodone with acetaminophen in Percocet®
  • Hydromorphone under the brand name Dilaudid®
  • Butorphanol, under the brand name Stadol® a nasal spray (very addictive)
  • Tramadol, under the brand names ConZip®, Ultram®, or Ryzolt™3

How do narcotics work to treat migraine?

Narcotics work to relieve pain by binding to naturally occurring receptors on nerve cells in the brain. The most common variety for opioid pain killers are known as mu receptors. These stimulate pleasure centers in the brain, reduce the sensation of pain, and cause calm and sedation. The sensation of calm can also reduce the emotional upset a migraine sufferer can feel because of the pain.

What are some side effects of narcotics?

  • Nausea
  • Itching
  • Drowsiness
  • Confusion
  • Slowed breathing
  • Constipation
  • Urinary retention4
  • If itching is accompanied by rash, swelling of the lips, tongue or throat this is a sign of a serious allergic reaction. Seek immediate medical attention.

    These are not all the possible side effects of narcotics. Patients should talk to their doctor about what to expect with treatment with narcotics.

    What else should I know about narcotics?

    Because narcotics cause drowsiness, they should not be taken with alcohol or any other drug that is sedating. Also don’t take narcotics if you will be doing any potentially dangerous activity such as driving, operating heavy machinery, or working at heights.4

    Before starting any Narcotic, talk to your doctor if you have:

    • Disorders of Respiratory Function or Control such as asthma and chronic lung disease
    • Chronic liver or kidney disease
    • BPH, benign prostatic hyperplasia or benign prostatic hypertrophy
    • Increased intracranial pressure
    • Hypersensitivity reactions

    You should begin no medication or supplement without first checking with your health care provider and should let them know of any other prescriptions, OTCs, and herbals you are taking to ensure there are no interactions.

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