pain medication Archives - Mayo Clinic News Network

Mayo Clinic Minute: 3 things to know when using Narcan during an opioid overdose

Marty Velasco Hames — Wed, 29 Mar 2023 14:00:00 +0000

The Food and Drug Administration (FDA) approved Narcan, 4 milligram (mg) nasal spray for over-the-counter sale. Narcan is a nasal spray version of naloxone, a rescue medicine that can be administered in the event of an opioid drug overdose. The FDA approval will pave the way for the medication to be sold in grocery stores, convenience stores, vending machines and other retail locations without a prescription.

Opioids are one of the most commonly prescribed medications to treat acute pain. Opioids are a class of drugs, including medications such as fentanyl, morphine and oxycodone. These medications work by blocking pain receptors in the central nervous system.

What makes opioids effective, is also what makes them dangerous due to risks associated with addiction and overdoses. Opioid misuse is skyrocketing. According to the Centers for Disease Control and Prevention, opioids are now the main driver of drug overdose deaths in the U.S.

Dr. Holly Geyer, a Mayo Clinic addiction medicine specialist, points out three important things to know when using naloxone that can help save someone's life.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (:56) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

When to use

If you suspect someone is having an opioid overdose, Dr. Geyer recommends administering Narcan immediately. She says proceed even if the person is unconscious.

How to use

"You're going to put that person on their side in the recovery position, making sure that your surroundings are safe, and then administer it by just putting it (the nozzle) inside the nostril and giving it a squeeze," explains Dr. Geyer.

How it works

Narcan works by temporarily blocking the effects of an opioid. "Naloxone goes through the bloodstream, straight to that part of the brain," says Dr. Geyer. "It knocks off the opioid from that receptor, binds to it and prevents the opioid from having an effect."

Call 911 immediately

Dr. Geyer says it is critical to remember that Narcan's effects are only temporary and may last only minutes. "It is always a medical emergency if Naloxone is given. Call 911 right away," says Dr. Geyer.

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Additional content:

Dr. Geyer is an addiction medicine specialist at Mayo Clinic and author of a new book, "Ending the Crisis: Mayo Clinic's Guide to Opioid Addiction and Safe Opioid Use."

Dr. Geyer explains more about the book

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where safety protocols were followed.

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Home Remedies: Does kratom work for opioid withdrawal?

Dana Sparks — Thu, 31 May 2018 21:30:47 +0000

Kratom, an herbal extract that comes from the leaves of an evergreen tree grown in Southeast Asia, can be chewed, and dry kratom can be swallowed or brewed. Kratom extract also can be used to make a liquid product.

Kratom is promoted as an aid in overcoming withdrawal from opioid medications. It's also sold as an energy booster; mood enhancer; appetite suppressant; treatment for cramps, panic attacks and diarrhea; and a pain reliever. Some people who practice Asian traditional medicine consider kratom to be a substitute for opium.

But research suggests that it leads to more health problems than it solves.

"It’s unregulated, so it can’t be prescribed by a health care provider, and the doses are all over the map," says Dr. Tyler Oesterle, a Mayo Clinic Health System psychiatrist and chemical dependency expert. "Just because it says a certain dose on the package doesn’t mean that’s the dose you’re actually getting, nor does it mean that’s the actual substance that you’re getting."

At low doses, kratom acts as a stimulant, making users feel more energetic. At higher doses, it reduces pain and may bring on euphoria. At very high doses, it acts as a sedative.

"It [kratom] does have some opioidlike properties and, so, you're replacing the opioid for an opioidlike substance," says Dr. Oesterle. "If you take a substance that’s opioidlike and it activates those opioid receptors, the receptors say, 'OK, we’ve got our opioid again.' It becomes something else you have to withdraw from again."

Natural but not safe

Because kratom may seem to ease withdrawal symptoms, researchers have studied it as a potential treatment. The evidence suggests that rather than treating addiction and withdrawal, the use of kratom may lead to them.

"We have no research associated with what’s the right amount, what are the risky amounts for individuals, what are some medications that might cross-react and make it more risky," says Dr. Oesterle. "We just don’t have a full understanding of what those things might be. But we know it’s a very potent substance and it potently activates those receptors."

Watch: Dr. Osterle discusses the use of kratom.

Journalists: Broadcast-quality sound bites with Dr. Oesterle are in the downloads.

In one study, people who took kratom for more than six months experienced withdrawal symptoms similar to those that occur after opioid use. Over time, people who use kratom may develop cravings for it and need the same medications that are used to treat opioid addiction, such as buprenorphine and naloxone. When kratom is used during pregnancy, the infant may experience symptoms of withdrawal after birth.

As with pain medications and recreational drugs, it is possible to overdose on kratom. The treatment for kratom overdose is similar to that for opioid overdose, and people experience many of the same treatment problems. Although people may enjoy the good feelings that kratom can produce, kratom has not proved to be an effective treatment for opioid withdrawal.

Side effects, safety concerns

Although people who take kratom believe in its value, researchers who have studied kratom think its side effects and safety problems more than offset any potential benefits.

"Too much kratom can cause all the same issues that too much opium would cause," says Dr. Oesterle. "Decreased breathing all the way up to what we call respiratory suppression, which is the stopping of breathing. It can cause seizures. It can cause comas, dizziness, you know, depression. All these kind of really negative effects that we – we see a lot in opioids, but we can also see this in kratom, as well."

Kratom has a number of known side effects, including weight loss, dry mouth, chills, nausea and vomiting, changes in urine and constipation, liver damage, and muscle pain. Kratom also affects the mind and nervous system, leading to dizziness, drowsiness, hallucinations and delusion, depression and delusion, breathing suppression, seizure, coma and death.

Kratom takes effect after five to 10 minutes, and its effects last two to five hours. The effects become stronger as the quantity taken increases. In animals, kratom appears to be more potent than morphine.

Many of the problems that occur with pain medications happen when these drugs are used at high doses or over a long period. It's not known exactly what level of kratom is toxic in people, but, as with pain medications and recreational drugs, a kratom overdose is possible.

"We can see development of psychotic symptoms," says Dr. Oesterle. "We can see depression. We can see anxiety. All these things have been reported with kratom. As we try to understand this substance and we start to research it, it’s actually been observed by health care providers as they’ve seen patients that have come in and utilized this substance." Dr. Oesterle says kratom has never been formalized the way other medicines are formalized.

"We know chronic use we know leads to addiction to the kratom," says Dr. Oesterle. "We also know that it can lead to things like liver failure, lead to excessive use like overdosing, which can again lead to respiratory suppression and then death."

Dr. Oesterle reiterates that the main concern is the replacement of one opioid with another opioidlike substance that is much less understood and regulated. "I see much more risk associated with bringing the substance in to an already vulnerable patient population that has gotten addicted to opioids. They’re struggling with opioids, and they want to get off opioids. And, then, they introduce this new substance into their lives that can be very addictive, very problematic. And, then, they just end up developing worse issues than they had in the beginning."

Dr. Oesterle says there are some good medicines to help with opioid withdrawal that are much safer and better understood.

This article is written by Mayo Clinic staff. Find more health and medical information on mayoclinic.org.

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Mayo Clinic Minute: Aspirin for heart health not headaches

Jason Howland — Thu, 17 May 2018 06:00:12 +0000

Once the go-to pain reliever in the medicine cabinet, aspirin's identity has changed a lot in the past century. No longer recommended as a treatment for pain, it's now prescribed by health care providers to help some patients' heart health.

Jason Howland has more in this Mayo Clinic Minute.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:00) is in the downloads. Read the script.

The old cliché is "Take two aspirin and call me in the morning." A mainstay in medicine cabinets for more than 100 years as a popular pain reliever, the take on aspirin now by health care providers is much different.

"Aspirin isn't really used anymore to treat pain," says Dr. Carrie Krieger, a clinical pharmacist at Mayo Clinic.

Instead, aspirin often is prescribed to reduce the chances of heart attack and stroke for those at high risk.

"It's an 81-milligram dose of aspirin or not more than 325 milligrams of aspirin that's recommended for certain patients and in certain cases once a day," says Dr. Summer Allen, a Mayo Clinic family physician.

The chemical makeup of aspirin creates an anti-platelet effect on the blood that keeps it from clotting. Taking too much can cause bleeding problems. And children should almost never take aspirin.

"Children can develop something called Reye's syndrome," says Dr. Krieger.

So while it might be over-the-counter, long-term use should only be doctor's orders.

"Where people run into problems is the daily and regular use of it for long periods of time," says Dr. Allen.

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Mayo Clinic Minute: The emergency department and opioid prescriptions

Dana Sparks — Thu, 10 May 2018 06:00:50 +0000

Many people think emergency departments tend to overprescribe opioids for people suffering from acute pain. However, a 2017 study published in Annals of Emergency Medicine found that's not true. According to Dr. Molly Jeffery, lead author of the study and scientific director of the Mayo Clinic Division of Emergency Medicine Research, the research revealed that the opioid prescriptions given in the emergency department are limited.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:00) is in the downloads. Read the script.

Opioid pain medication can hook people into addiction quickly. Some worry that emergency departments are a major source for these drugs.

“One thing that sort of everybody thinks they know about opioids is that, in the emergency department, they give opioids out like candy,” Dr. Jeffery says.

Not true, she says. Dr. Jeffery and her colleagues published a study that found opioid prescriptions from the emergency department are written for a shorter duration and smaller dose than those written elsewhere. They also found that patients with acute pain who receive an opioid prescription in the emergency department are less likely to progress to long-term use.

“What we want to avoid is people having a large prescription and having lots of pills leftover because, at that point, it becomes a risk for their family members and other people who come to their home,” says Dr. Jeffery.

Centers for Disease Control and Prevention guidelines caution against exceeding a three-day supply or 50 milligrams of morphine equivalent per day for acute pain.

“And, so, limiting prescriptions to three to seven days is a good balance.”

The post Mayo Clinic Minute: The emergency department and opioid prescriptions appeared first on Mayo Clinic News Network.

Housecall: Healthy snacking

Laurel Kelly — Mon, 30 Oct 2017 11:00:07 +0000

THIS WEEK'S TOP STORIES
Snacks: How they fit into your weight-loss plan
Eating between meals doesn't have to be a guilty pleasure. Well-planned, healthy snacks can help you manage hunger and reduce bingeing at mealtime. Discover creative ways for healthy snacking without sabotaging your diet goals.

7 benefits of regular physical activity
You know exercise is good for you, but do you know how good? From boosting your mood to preventing heart disease to improving your sex life, find out what exercise can do for you.

EXPERT ANSWERS
Does my child need a flu shot this year?
The Centers for Disease Control and Prevention recommends a yearly flu vaccination for all children 6 months and older, ideally given as soon as the vaccine is available each year. Learn more about this year's recommendation for a flu shot rather than the nasal spray vaccine from Dr. James Steckelberg, a Mayo Clinic infectious diseases expert.

Is canned pumpkin healthier than fresh?
Fresh foods generally have a higher nutrient content than do cooked or canned foods. But in this case, both fresh pumpkin and canned pumpkin are packed with nutrients, such as potassium, vitamin A and iron. Learn more from Katherine Zeratsky, a Mayo Clinic dietitian.

PLUS ADDITIONAL HIGHLIGHTS
Minimally invasive surgery
Video: Pain medication safety
Nail fungus: An overview
Sprains and strains

HEALTHY RECIPES
Lemon rice with golden raisins and almonds
Sweet potato gnocchi
Grilled mango chutney
Lentil ragout

HEALTH TIP OF THE WEEK
Time for new walking shoes?
If you walk regularly, your athletic shoes are bound to show signs of wear. And, even if they still feel comfortable, they might not be providing enough support or shock absorption. Pay attention to the condition of your shoes. If the outsole is worn through, it's time for a new pair.

Need practical advice on diet and exercise? Want creative solutions for stress and other lifestyle issues? Discover more healthy lifestyle topics at mayoclinic.org.

Receive a free e-subscription to Housecall and other health newsletters.

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Housecall: It’s time to get physical

Laurel Kelly — Mon, 03 Apr 2017 18:30:45 +0000

THIS WEEK'S TOP STORIES
Aerobic exercise: Top 10 reasons to get physical
Whatever your age, weight or athletic ability, regular aerobic activity, such as walking, bicycling or swimming, can help you live longer and healthier.

Healthy cooking techniques: Boost flavor and cut calories
You don't need extra salt or fat to make dishes taste great. Capture the flavor and nutrients of food with these simple cooking tips.

EXPERT ANSWERS
Does alcohol and tobacco use increase my risk of diabetes?
Find out how the chances of having Type 2 diabetes can jump with alcohol and tobacco use.

Can anxiety be a cause of high blood pressure?
Discover the link between periods of anxiety and dramatic spikes in blood pressure.

PLUS ADDITIONAL HIGHLIGHTS
Tuberculosis: Symptoms and causes
Video: Pain medication safety
Poisoning: First aid
Epilepsy: Symptoms and causes

HEALTHY RECIPES
Breakfast burrito
Rotelle pasta with sun-dried tomato and black olive sauce
Chicken sausage meatballs
Fresh fruit smoothie

HEALTH TIP OF THE WEEK
Stop your next migraine before it starts
Medication is a proven way to treat and prevent migraines, but that's only part of the story. These healthy habits can sometimes stop migraine pain before it starts:

Establish regular sleep hours. Take time to unwind at the end of the day. If you can't fall asleep, read or do another quiet activity until you become drowsy.
Eat at about the same time every day. Avoid foods that seem to trigger migraines.
Exercise regularly.
Keep stress under control.

Need practical advice on diet and exercise? Want creative solutions for stress and other lifestyle issues? Discover more healthy lifestyle topics at mayoclinic.org.

NOW BLOGGING
Nutrition-wise: Family meals and your weight
Sharing meals as a family can have health benefits. Just avoid these missteps

Receive a free e-subscription to Housecall and other health newsletters.

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Opioid crisis: Video with Mayo experts available for media

Sharon Theimer — Thu, 22 Sep 2016 19:15:29 +0000

ROCHESTER, Minn. — Each day, 78 people in the U.S. die of opioid overdoses, and more than 1,000 are treated in emergency departments for opioid misuse, federal figures show. In a series of broadcast-quality, 60-second videos available for media use, Mayo Clinic anesthesiologist and pain medicine expert W. Michael Hooten, M.D., and gastroenterologist Michael Camilleri, M.D., discuss the opioid epidemic and the dangers associated with inappropriate use of prescription pain medication.

These seven Mayo Clinic Minutes will be available for download on the Mayo Clinic News Network.

Watch series promo.

View the complete series:

Journalists and members of the public can join Dr. Hooten to discuss the nation’s opioid crisis on Sept. 22 at 4:30 p.m. EDT. Dr. Hooten will explain what opioids are and what they do, how people become addicted, and what help is available to manage chronic pain.

Watch archive recording of the Sept. 22 chat.

To interview Dr. Hooten or Dr. Camilleri, contact Sharon Theimer, Mayo Clinic Public Affairs, at newsbureau@mayo.edu or 507-284-5005. For questions about the Mayo Clinic News Network, contact Dana Sparks, Mayo Clinic Public Affairs, at sparks.dana@mayo.edu.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

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Mayo Clinic Health Letter: Highlights from the March 2015 Issue

Fri, 27 Mar 2015 16:15:00 +0000

ROCHESTER, Minn. ― Here are highlights from the March issue of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit http://healthletter.mayoclinic.com/ or call toll-free for subscription information, 1-800-333-9037, extension 9771. Full newsletter text: Mayo Clinic Health Letter March 2015 (for journalists only).

Alternate medications to manage chronic pain

Pain medications might not work well for chronic pain ― pain that doesn’t go away with time. The March issue of Mayo Clinic Health Letter covers other types of medications and strategies to consider as part of long-term pain management.

Deciding on potential drug therapy for chronic pain usually involves analysis of the cause or causes of pain and knowing which type of drugs may be beneficial. Pain medications typically work well for pain resulting from headache, an injury or surgery. These same medications can lose their effectiveness over time, and some may even make pain worse or cause unacceptable side effects. Other options include:

MEDIA CONTACT: Brian Kilen, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

Antidepressant drugs ― These drugs are commonly used for multiple types of chronic pain, such as fibromyalgia, low back pain, headaches, diabetic neuropathy and other forms of nerve pain. In some people, antidepressants appear to help with pain, independent of their possible effect on depression. They can also improve depression symptoms, which can be caused by chronic, unrelieved pain. Antidepressants usually don’t lose their effect over time, and they may increase the effect of other pain drugs.
Anti-seizure medications ― Several drugs developed primarily to control epileptic seizures have been found to help control stabbing or shooting pain that can result from nerve damage or impaired communication in the central nervous system. When a nerve is injured or functions abnormally, certain nerve receptors that communicate pain to the brain may fire inappropriately. Anti-seizure medications can help reduce this activity and decrease pain levels.
Nonmedication strategies ― Using drugs to manage chronic pain usually works best as part of a larger plan that may include regular exercise, physical activity, physical therapy, counseling, stress management, massage and other components. Visiting a comprehensive pain rehabilitation center may be worth considering, especially for those who have struggled to find effective pain management. Reducing or eliminating unhelpful medications, often with a planned tapering of the drugs, is a common occurrence in pain rehabilitation programs.

Blood pressure guidelines refined for older adults, those with diabetes or kidney disease

Blood pressure guidelines have been refined for older adults and people with diabetes or kidney disease. The March issue of Mayo Clinic Health Letter covers these changes and why they were made.

High blood pressure is a common and serious health problem in the U.S. High blood pressure can lead to significant health risks including heart attack, stroke, heart failure and kidney failure and other organ damage. Older adults are particularly at risk. More than half of adults over age 65 and close to 80 percent of adults over age 75 have high blood pressure.

Normal blood pressure is considered to be less than 120/80 mm Hg. For some, high blood pressure tends to develop over many years without an exact cause. For others, an underlying condition, such as kidney or thyroid disease, causes high blood pressure.

The goal of treating high blood pressure is to keep it within a range that avoids damage to the arteries, heart, kidneys and brain. That range varies somewhat for subsets of patients.

The most recent guidelines, from the Eighth Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, were published in 2014. For those with high blood pressure, guidelines recommend blood pressure lower than:

150/90 mm Hg for healthy adults age 60 and older. This is slightly higher than previous guidelines.
140/90 mm Hg for healthy adults younger than 60.
140/90 mm Hg for adults with diabetes or kidney disease. This also is slightly higher than previous guidelines.

One of the underlying principles of the new guidelines is that more aggressive treatment isn’t always better at improving health, nor is it backed by solid evidence, especially in the case of older adults and those with diabetes or chronic kidney problems. Less aggressive treatment goals reduce the intensity of treatment, which also makes for fewer side effects.

It’s good to remember that guidelines are based on data derived from large numbers of carefully selected people ― and there are varying opinions on which blood pressure goals are best for optimal health. Patients should work with their providers to determine the best strategies to reduce the risk of heart disease, stroke and other consequences of high blood pressure.

Fostering thankfulness, improving well-being

Scientists are finding that people who are habitually grateful reap greater happiness, more positive relationships, increased sense of fulfillment and even sleep better, according to the March issue of Mayo Clinic Health Letter.

While everyone feels grateful at times ― for a gift, extra help, a rewarding job, or natural beauty ― transient moments of thankfulness aren’t enough to explain the wider concept of gratitude. Gratitude, especially as it correlates to a higher sense of well-being, focuses on noticing and appreciating the positive aspects of life. Practicing gratitude means being content in the moment, despite the imperfections of life.

Dr. Amit Sood

Mayo Clinic doctor Amit Sood, M.D., has authored several books on training the brain to decrease stress, increase resilience and live meaningfully. Here are some of his suggestions to foster gratitude.

Start the day with gratitude: Begin the day by thinking of five people to whom you are grateful. The day starts on a more positive note when it begins with grateful thoughts.

Be thankful for simple things: Throughout the day, mentally note things easily taken for granted, electricity, running water, clean clothes or a cup of coffee.

Look for the positive in the negative: Try to see struggles as necessary forces that focus energy on what’s really important. Be thankful for a flexible mind that allows adversity to help you learn and grow.

Acknowledge your riches: If you are feeling bad, count your blessings, such as health, home, freedom, a job or loved ones.

Keep a gratitude journal: As you contemplate people and things you’re grateful for, write them down. Do it before you sleep so the last thoughts of the day are positive and sleep is restful. Refer back to the journal on rough days.

Say thank you: Express gratitude to others in words and deeds. Say thank you in person for a kind action or write a note to express gratefulness for having a person in your life.

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Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 1-800-333-9037 (toll-free), extension 9771, or visit http://www.HealthLetter.MayoClinic.com

About Mayo Clinic Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

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MAYO CLINIC RADIO

Dana Sparks — Fri, 28 Jun 2013 21:33:56 +0000

On Saturday, June 29, Randy Shelerud, M.D., will join us to discuss back pain. Who’s a candidate for surgery? Why are smoking and obesity bad for your back? We’ll learn the correct way to lift heavy objects and find out about the best back pain medication.

MYTH OR MATTER OF FACT: Firmer mattresses are better for your back.

Listen Saturday 9-10 a.m. CDT http://radio.mayoclinic.org/ or on I Heart Radio.

Follow #mayoradio and tweet your questions during the show.

Listen to this week’s Medical News Headlines at News Segment June 29, 2013 (right click MP3).

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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Study Suggests Those Who Have Chronic Pain May Need to Assess Vitamin D Status

Thu, 07 Oct 2010 11:00:27 +0000

Mayo Clinic research shows a correlation between inadequate vitamin D levels and the amount of narcotic medication taken by patients who have chronic pain. This correlation is an important finding as researchers discover new ways to treat chronic pain. According to the Centers for Disease Control and Prevention, chronic pain is the leading cause of disability in the United States. These patients often end up taking narcotic-type pain medication such as morphine, fentanyl or oxycodone. This study found that patients who required narcotic pain medication, and who also had inadequate levels of vitamin D, were taking much higher doses of pain medication — nearly twice as much — as those who had adequate levels. Similarly, these patients self-reported worse physical functioning and worse overall health perception. In addition, a correlation was noted between increasing body mass index (a measure of obesity) and decreasing levels of vitamin D. Study results were published in a recent edition of Pain Medicine. This is an important finding as we continue to investigate the causes of chronic pain, says Michael Turner, M.D., a physical medicine and rehabilitation physician at Mayo Clinic and lead author of the study. Vitamin D is known to promote both bone and muscle strength. Conversely, deficiency is an under-recognized source of diffuse pain and impaired neuromuscular functioning. By recognizing it, physicians can significantly improve their patients pain, function and quality of life.

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