The world of pain and pain relieving drugs has a vocabulary all its own. Here are some of the concepts, terms, and definitions used to describe the basics of pain, painkilling drugs, the benefits and dangers involved, the legal ramifications to both patients and doctors, and the necessary safety precautions that must be in place.
The list is divided into three parts. This is part III (narcotics / narcotic drugs --> tolerant / tolerance).
Link here for Part I - 5th vital sign --> chronic pain.
narcotics or narcotic drugs
The word "narcotic" comes from a Greek roots "Narkos" or "narokosis," which mean sleep, numb or stupor. Many of the drugs prescribed for pain relief are considered narcotic drugs because they dull the senses which relieves that pain. But not all pain relievers are narcotic because not all of them make people sleepy.
The word is usually used incorrectly as a term for illegal drugs. However, not all narcotics are used illegally, and not all illegal drugs are narcotics.
Commonly recognized "real" narcotic drugs are morphine, heroin, and the many opioids described below.
NSAID (pronounced en-sed) stands for nonsteroidal anti-inflammatory drug, a class of drug that relieves pain by reducing inflammation. NSAIDs are non-narcotic and non-opoid. They include aspirin, ibuprofen (Motrin), celecxib (Celebrex), naproxen (Aleve or Naprosyn) and others.
opium, opiates, opioids (and the differences among opium, opiates and opioids)
Opium is a substance derived from some poppy plants (bringing to mind the poppies in the Wizard of Oz.) It is narcotic in nature (see above) and as a result, is the main ingredient in many pain relievers.
Opiates are the drugs that are developed directly from opium, such as morphine and codeine.
Opioids are opiates which have been combined with a synthetic substance. Some commonly recognized opioids are Oxycodone, Hydrocodone, Percocet and others.
Many people use the two terms, opiates and opioids interchangably, even though they are not really the same thing.
opiate or opioid naive
A patient who has not recently used any opiate or opioid drug may be considered opiate naive. The body hasn't developed any tolerance, the side effects may be more pronounced, and that patient must be monitored carefully in the first days or weeks of taking a prescription for an opioid, as his or her body adjusts to the drugs.
Determining whether you are opiate naive will help you stay safe with pain drugs.
These are agreements that doctors provide to patients to help them take responsibility for their management of their pain medication. Learn more about pain contracts.
On the dark side of drug prescribing are pill mills - doctors, pharmacies and clinics that over-prescribe narcotics and opioids, without regard to the clinical need for them; rather, simply to sell those drugs at a profit.
Pill mills are highly illegal operations and those who work at them, and those who receive their drugs from them put themselves at legal risk.
schedules (Controlled Substances)
The CSA divides all controlled substances into five categories or schedules. Schedule I substances are the most addictive with the highest risk of abuse. Schedule V drugs have the lowest potential for abuse and contain small amounts of narcotics.
Link here to a list of the schedules and what each one represents.
So many of the pain relieving drugs are controlled substances, and are becoming increasingly difficult to obtain through legal, prescription channels. As a result, black markets, selling the drugs illegally, gives the drugs "street value" - they can be purchased on the street from strangers for large sums, by desperate people.
tolerant or tolerance
When a body becomes tolerant of a drug or other substance, it means that more of the drug is needed to achieve the same effect. In particular, opioids may need to be ingested in increasing doses in order to achieve the same level of pain relief over time.