In his new autobiographyMatthew Perry revealed that his colon burst due to his addiction to opioid painkillers. The actor, 53 years old, was hospitalized for two weeks and required a colostomy bag to keep him alive for nine months.
Many peoplePrescription opioids like codeine and hydrocodone are used to treat pain. This may seem alarming. Can prescription opioids cause your colon to burst with pain?
Opioids can reduce the activity of the gut, so they are often used to treat diarrhea. Opioids can cause constipation in people who use them.
Over time, the body develops tolerance to many of the effects of opioids, but constipation tends not to improve – in fact, it can become more severe.
Sometimes, the colon can become irreversible in extreme cases. Opioid medication can also be used to treat other problems in the colon. The bowel can perforate – as it did in Perry’s case – but this is quite rare.
Opioids have long been recognized for their powerful pain-killing properties. Many thousands of years. Perry is one of those people who become addicted, but most people who take them to relieve pain are not.
They can be dangerous and have unexpected side effects. Suppressed breathing is the most hazardous.
The respiratory center of the brainstem is depressed by opioids, which can cause people to stop breathing if they are in excess. This is one of the most dangerous pharmacological effects that opioids can have. The body may develop a tolerance for opioids and the sedation will decrease, but the effects on breathing don’t diminish as much.
Even if they don’t seem sedated, people can experience low blood-oxygen levels if their doses are increased. This could be due to: Tom PettyAnd PrinceIt was the opioids that caused my death.
Long-term drug use can lead to a decrease in pain relief. Doses are therefore often increased.
Strangely, pain can actually get worse at 120mg or more of oral morphine per day. This is known as Opioid-induced hyperalgesia. This is why it happens, but we don’t know why.
Opioids are not like alcohol. However, they can cause tissue damage. Fall in testosterone (hypogonadism) in men. Hypogonadism can also occur in women but it is less common. It is not clear if it can be reversed.
Not just for the body
High-dose opioids can lead to reversible cognitive, and behavioral changes. People are less able to concentrate and pay attention due to the sedative effects.
Abstract thinking can also be affected by opioids. It is difficult to see the bigger picture or understand situations from multiple perspectives.
People lose interest and experience less pleasure. Family and social life can be more limited or stopped altogether. This behavior change can often be attributed more to the underlying condition and pain than to the stultifying effects.
This is not a fatal outcome. There are options, even if people have been using opioids for a while.
Low doses work more than high doses and some people are able to live without any pain medication. You can taper doses with help but it is difficult to do this once you are taking high doses.
Stop using opioids
It has been assumed that opioid doses rise slowly. This makes it difficult for people to notice that there is a problem until it is too late.
In a Recent studiesMy colleagues and me looked at the primary records of patients who were taking high-dose opioids in a clinic in Wales. None of these records showed a gradual, long-term increase. In every case, people reached doses greater than or equal to 120mg oral morphine a day quickly – in weeks or even days. This can occur at the start of treatment or after years of taking lower doses.
It was a one-way street. After crossing the high-dose threshold, no one returned to low doses.
In An earlier studyWe described an intervention in which patients who were taking high dose opioids were quickly switched to low-dose methadone (an opioid). Methadone is slowly excreted from the body so this was why it was chosen. Methadone maintains a constant blood level which helps to minimize the dosage.
Twenty patients experienced significant improvements in their activity levels and well-being. Patients were offered the chance to go back to their prior drug regimens if they desired, but they did not do so. Some people reported improvements in their pain or in managing it.
While I wouldn’t advocate for people to avoid opioids completely, it is possible that small doses of opioids don’t work long-term.
Rob PooleProfessor of Social Psychiatry Bangor University
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