If Demerol is not supposed to used in treating long term pain management, how long would it be used for?
October 8th, 2009 | by Michael |
juli492 asked:
If Demerol is not safe for long term treatment of pain because of toxic buildup what would be the generally accepted period of time that it is safe to use? Would it be days, weeks, etc? The Michael Jackson case has sparked my curiosity. Thank you.
LYNN
If Demerol is not safe for long term treatment of pain because of toxic buildup what would be the generally accepted period of time that it is safe to use? Would it be days, weeks, etc? The Michael Jackson case has sparked my curiosity. Thank you.
LYNN
2 Responses to “If Demerol is not supposed to used in treating long term pain management, how long would it be used for?”
By Mathieu on Oct 9, 2009 | Reply
Demerol is used for the treatment of chronic pain and acute pain. Many doctors prefer Demerol to other opiate analgesics due to some of its unique properties (but it falls more out of favour every year). However, some of its unique properties involving the reuptake of monoamine neurotransmitters (dopamine, serotonin, norepinephrine) and its almost cocaine like stimulation and anesthetic ability (cocaine is a local anesthetic) plus its very fast action makes it more addictive than other IV drugs, it has multiple major drug interactions, does not fully respond to opiate antagonists like Naloxone (for use in OD situations as an antidote), and it is actually toxic (a neurotoxin).
One things opiates, especially naturally occurring and semisynthetic opiates, are known for are being “clean” drugs. This means that opiates like morphine do not interact with many neurotransmitters and receptors. So opiates have targeted action. Demerol acts with all sorts of neurotransmitters and has active metabolites that can damage the body. It is almost like morphine and cocaine mixed together hitting the brain in seconds after given IV. Thus it is far more addictive and has the potential for many problems (including cardiac).
But it is not exactly a bad drug. Short term use is normally safe and people with certain medical conditions or who do not respond well to morphine and related drugs might use Demerol. It is available in tablet forms that people can take at home for pain. And it is very rare for IV Demerol to be needed except in hospital or home hospice. I can’t imagine Jackson was in enough pain that he required daily shots of IV Demerol. Oral pain medication is typically effective in all but extreme situations.
By greydoc6 on Oct 12, 2009 | Reply
Toxic buildup is not the problem, addiction is. Demerol is a derivative of opium, similar to morphine. It is very effective as a pain killer, especially after a surgical procedure. Thus, it is almost ideal for short term use.
For reasons that are not completely clear, some persons are more prone to addiction than others. Giving Demerol to these persons over an extended period of time is inadvisable. Many physicians are not astute as to the warning signs. Asking for repeated prescription refills is one huge red flag.