Painkiller warning

Ian Armstrong, M.D.
Diplomate, American Board of
Prescribed Narcotic Painkillers: Although they may be medically indicated for the control of pain and can be
safe when taken as prescribed, prescribed narcotic painkillers (i.e., pain relievers, opioids, narcotics, etc.) are
drugs with high abuse potential. Chronic use of these drugs can result in both dependence and increased tolerance.
For example, you may find that the drug no longer works for you at the prescribed dosage, and you may feel you
need to take more of the drug to give you the same relief. If this happens, contact your doctor, do not simply take
more medication. A side effect of prescribed narcotic painkillers is a feeling of euphoria. It is this side effect that
makes these drugs highly sought after by those wishing to free themselves from painful emotions.
Common Prescribed Narcotic Painkiller Products Include: Actiq Lozenges/Duragesic Patches (Fentanyl),
Anexia/Lorcet/Lortab/Maxidone/Norco/Vicodin/Zydone (Hydrocodone + Acetaminophen), Avinza/Kadian/MS
Contin/M-Eslon/MSIR/Oramorph SR/Roxanol/Statex (Morphine), Buprenex (Buprenorphine), Capital with
Codeine suspension/Tylenol with Codeine (Codeine + Acetominphen), Darvocet/Wygesic (Propoxyphene +
Acetaminophen), Darvon-N/Darvon Pulvules (Propoxyphene), Darvon Compound-65 Pulvules (Propoxyphene +
ASA + Caffeine), Demerol (Meperidine), Dilaudid (Hydromorphone), Dolophine/Methadose (Methadone),
Empirin with Codeine (ASA + Caffeine + Frosst 292), Endocodone/OxyContin/OxyFAST/OxylR/Percolone/
Roxicodone/Supeudol (Oxycodone), Floricet with Codeine (Acetaminophen + Butalbital + Caffeine + Codeine),
Fiorinal with Codeine (ASA + Butalbital + Caffeine + Codeine), Levo-Dromoran (Levorphanol), Nubain
(Nalbuphine), Numorphan (Oxymorphone), Percocet/Roxicet/Tylox (Oxycodone + Acetaminophen), Percodan
(Oxycodone + ASA), Soma Compound with Codeine (Carisoprodol + ASA + Codeine), Stadol/Stadol NS
(Butorphanol), Talacen (Pentazocine + Acetaminophen), Talwin/Talwin NX (Pentazocine), Vicoprofen
(Hydrocodone + Ibuprofen), or other similar products.
Prescribed Narcotic Painkiller Warnings: Because these drugs may make you drowsy, less alert, and/or unable
to function well physically, you should take precautions. Do not drive a car. operate machinery, or perform any
other potentially dangerous activities while taking prescribed narcotic painkillers. Do not drink alcohol while
taking prescribed narcotic painkillers — the side effects of the painkiller can be increased. Do not take other drugs
while taking prescribed narcotic painkillers without your doctor’s approval. If prescribed narcotic painkillers are
taken with certain other drugs, the effects of either may be increased, decreased, or altered. It is especially
important to check with your doctor before combining these drugs with the following: antianxiety drugs (i.e.,
Valium, Ubrium, Xanax, Klonopin, etc.), antidepressants — Tricyclics (i.e., Elavil, Tofranil, etc.), other
antidepressants — MAO inhibitors (i.e., Nardil, Parnate, etc.), antihistamines (i.e., Benedryl, Tavist, etc.), major
tranquilizers (i.e., Thorazine, Haldol, etc.), other narcotic painkillers, and other central nervous system depressants
(i.e., Halcion, Restoril, Ambien, Dalmane, etc.). Your doctor prescribing these drugs should know if you are
pregnant, breast feeding, or have any medical problems, including: trouble breathing, lung problems, head injury,
liver or kidney problems, adrenal gland problems (i.e. Addison’s Disease), convulsions/seizures, alcoholism,
hallucinations or other severe mental problems, or any past or present substance abuse or drug addiction.
Prescribed Narcotic Painkiller Abuse: Prescription drug abuse is the term commonly used to describe the
excessive and harmful usage of prescribed drugs. A prescribed narcotic painkiller is abused if not taken exactly as
prescribed. You should not increase the amount or frequency without your doctor’s approval. You should not take
this drug for any reason other than the one prescribed. You should not give this drug to others who may have
similar symptoms. Prescribed narcotic painkillers are only meant to be taken for physical pain relief, not for
emotional pain relief.
Ian Armstrong, M.D.
Diplomate, American Board of
Prescribed Narcotic Painkiller Overdose: Any medication taken in excess can have serious consequences.
A severe overdose of prescribed narcotic painkillers can be fatal. If you suspect an overdose, seek emergency
medical treatment immediately. Symptoms of an overdose include: blood disorders, bluish tinge to skin, cold and
clammy skin, extreme sleepiness progressing to a state of unresponsiveness or coma, general feeling of bodily
discomfort, heart problems, heavy perspiration, kidney problems, limp muscles, liver failure, low blood pressure,
nausea, slow heartbeat, troubled or slowed breathing, and/or vomiting.
Prescribed Narcotic Painkiller Withdrawal: Stopping these drugs suddenly will bring on symptoms of
withdrawal. Initial withdrawal symptoms usually begin within hours of the last dose and may include: cravings,
running nose, excessive sweating, insomnia, and violent yawning. Those who have been addicted to prescribed
narcotic painkillers for a long time may progress to severe withdrawal symptoms, including: chills, fever, muscle
spasms, abdominal pain, seizures, and coma. Consult your doctor for instructions on how to stop these drugs
slowly, to avoid uncomfortable symptoms.
Symptoms of Addiction of Prescribed Narcotic Painkillers: The following are symptoms of addiction:
showing relief from anxiety, changes in mood from a sense of well-being to belligerence, false feelings of self-
confidence, increased sensitivity to sights and sounds — including hallucinations: altered activity levels — such
as sleeping for 12 to 14 hours or hyperactive activity lasting for hours, unpleasant or painful symptoms when the
substance is withdrawn, and preoccupation with running out of pills.
Other Prescription Drugs that Are Addictive: Librium (Chlordiazepoxide), Klonopin/Rivotril (Clonazepam),
Tranxene (Clorazepate), Valium (Diazepam), Dalmane (Flurazepam), Pro-Som (Estazolam), Ativan (Lorazepam),
Restoril (Temazepam), Xanax (Alprazolam), Serax (Oxazepam), Halcion (Triazolam), Buspar (Buspirone),
Somnote/Aquachloral Supprettes (Chloral Hydrate), Benedryl/Banaril/Aliermax/Diphen/Dytuss/Sominex/
Tusstat/Truxadryl (Diphenhydramine), Nembutal (Pentobarbital), Sonata/Starnoc (Zaleplon), Ambien
(Zolpidem), Limbitrol (Chlordiazepoxide + Amitriptyline), Dexedrine (Amphetamine), Desoxyn/speed
(Methamphetamine), Soma (Carisoprodol), any unspecified benzodiazepine, any unspecified sleeping pill, or
other medications not mentioned above, but similar to the above.
Resources: If you suspect that you are becoming addicted to prescribed narcotic painkillers, speak with your
doctor prescribing the medications immediately, and contact the following resources:
1. Narcotics Anonymous (NA), World Service Office in Los Angeles, P.O. Box 9999, Van Nuys, CA 91409,
2. American Society of Addiction Medicine (ASAM), 4601 North Park Ave., Arcade Suite 101,
Chevy Chase, M.D. 20815, at (301) 656-3920, or visit 3. National Institute on Drug Abuse (NIDA) at 1-800-662-HELP, or visit
By signing below I am declaring that I have received, read, and understood the above information regarding the
addictive properties and warnings of prescribed narcotic painkillers, and will take my prescribed narcotic
painkillers exactly as prescribed.
Print Name:_______________________________ Signature: ____________________ Date: _________


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