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What is Demerol?

Demerol, the brand name for meperidine, is a narcotic analgesic and synthetic opioid. It is a powerful pain reliever when other pain medications are not strong enough to provide relief, and opioid treatment is one of the only options.

Meperidine binds to the mu-opioid receptor in the brain, just like morphine, creating the same toxicities and effects as morphine to provide pain relief.

Demerol's most common application is for severe pain relief during labor and childbirth. However, Demerol is also used to manage chronic pain and postoperative pain (after surgery).

Side Effects of Demerol

Hospitals and outpatient clinics do not use Demerol as often as they used to. This is because it is highly addictive to most people, has many instant side effects, and is toxic at high doses. Serious side effects of Demerol include:

  • Rapid heart rate or abnormal heartbeats
  • Blurred vision
  • Tremors or seizures
  • Head injuries from seizures and falling
  • Low blood pressure
  • Nausea and vomiting
  • Drowsiness
  • Maternal hypotension (low blood pressure)
  • Respiratory depression (slowed breathing)
  • Breathing problems (If Demerol is injected within 2 to 4 hours of delivering a baby, breathing difficulties can develop in some babies)
  • Dry mouth
  • Mood changes
  • Dizziness, lightheadedness

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Risks & Dangers of Use

Meperidine (Demerol) is an FDA-approved prescription drug. It is also a Schedule II controlled substance by the Drug Enforcement Administration (DEA), which is the highest level of drug control within the U.S., with medicinal use as an exception. The federal government tightly regulates the use of Demerol because of its likelihood of being abused or sold on the street for recreational use.

In the mid-nineteen eighties, it became internationally acknowledged in the world of medicine that prolonged Demerol use over several days leads to CNS excitation syndrome, which causes tremors, involuntary muscle jerks, mental confusion, emotional disruption, and seizures.

Drug Interactions

Demerol should not be taken with monoamine oxidase inhibitors (MAOIs). MAOIs are considered very effective anti-depressants and are also used to manage social phobia and panic disorder. Examples of MAOIs include rasagiline, selegiline, isocarboxazid, phenelzine, and tranylcypromine.

When opioid medication interacts with several of the other drug types listed below, dangerous side effects or death can occur. Before prescribing Demerol, a patient's doctor must assess if the patient has used or is currently using:

  • Narcotic medications — prescription cough medicine or other opioid pain medicine
  • Sedatives like Valium — such as alprazolam, diazepam, lorazepam, Xanax, Versed, Klonopin, and others
  • Drugs that make one sleepy or slow their breathing — such as medicine to treat mood disorders or mental illness, a sleeping pill, or a muscle relaxer
  • Drugs that affect serotonin levels in the body — such as medicine for depression/SSRIs, stimulant drugs, drugs that assist with Parkinson's disease, migraine headache medication, or even nausea and vomiting medicine
  • Alcohol and other central nervous system (CNS) depressants

Is Demerol Addictive?

Yes. Demerol is more addictive than most other opioid drugs. This is because it takes effect quickly and wears off fast, increasing a person's tolerance level and leading to dependence sooner. 

It is not recommended for pain reduction treatment, except for a few days, because of its highly addictive qualities. Demerol abuse through prolonged usage can quickly lead to drug dependence and tolerance. When this happens, the abuser will need more of the drug to feel its effects. This, in turn, leads to addiction. 

It also prompts the need for highly regulated measures by the Federal Government via the DEA and specialized treatment plans from doctors and medical professionals.

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Risk Factors for Demerol Abuse

Some people are more predisposed to Demerol abuse than others. There are risk factors that may influence the possibility that a person will become addicted to or abuse Demerol.

Those more at risk of developing opioid use disorder involving Demerol or any other form of opioid are:

  • People who do not know how, or are unable, to effectively manage stress
  • People with moderate to severe pain and are being treated with Demerol
  • People with family and friends who abuse Demerol
  • People with impulsivity problems
  • People with a family history of, and have experienced early exposure to, substance abuse

Abuse and Addiction Symptoms

Psychological dependence is one of the main signs of an opioid use disorder, as are drug cravings and the onset of opioid withdrawal symptoms when the drug wears off. Demerol is commonly abused by swallowing, injecting, smoking, or snorting the drug. On the street, Demerol is called juice, D, dillies, and dust

Demerol is appealing to drug users because it interferes with the way dopamine and norepinephrine react in the brain, which increases the "high" users feel. Frequent drug abuse leads to dependence and addiction.

Demerol addiction is suspected when an individual:

  • Lacks the ability to stop taking Demerol and has multiple unsuccessful attempts to stop
  • Has a drug tolerance which leads to increased self dosage
  • Takes more of the drug and for a longer period of time than intended for a single dose
  • Invents pain symptoms to get more of the drug or visits multiple doctors to try and get prescriptions for the drug
  • Shows a lack of interest in their daily lives or tasks they used to enjoy
  • Sleeps or is awake at abnormal times
  • Misses school or work often
  • Has decreased productivity
  • Is unreliable and cannot fulfill daily obligations
  • Has changes in appetite and eating habits
  • Loses weight
  • Has drastic mood swings 
  • Has a possible complete shift in personality
  • Continues using Demerol despite knowing the adverse consequences
  • Uses Demerol in situations that are risky, unclean, and hazardous
  • Participates in potentially illegal actions to obtain the drug

When a person who has become physically and/or psychologically dependent on Demerol stops taking the drug or reduces the amount they're taking, withdrawal symptoms may occur. This is because they have yet to adjust to the absence or the lack of Demerol in their body.

Demerol withdrawal includes symptoms like: 

  • Restlessness
  • Tearing up or runny nose
  • Nausea
  • Sweating
  • Chills
  • Pupil dilation
  • Abdominal cramps
  • Vomiting
  • Diarrhea
  • Loss of appetite and weight loss
  • Irritability
  • Anxiety
  • Weakness
  • Insomnia
  • Heightened blood pressure
  • Heightened heart rate
  • Increased respiratory rate

Addiction negatively impacts a person's emotional well-being, physical health, friendships and relationships, families, and economic well-being.

Effects of Demerol Abuse

Demerol abuse can lead to severe long-term effects, affecting the body and brain. These include:

  • Addiction
  • Brain damage
  • Deficiency in tissue oxygenation, also called hypoxia
  • Psychological and mental health problems (anxiety, depression, etc.)

One of the most dangerous effects of abusing Demerol is overdose. According to the Centers for Disease Control and Prevention (CDC), approximately 46 people die due to opiate overdose every day. Look out for signs and symptoms of Demerol overdose, which include:

  • Bluish nail beds, lips, and tongue
  • Blurry vision
  • Cold, clammy skin
  • Coma
  • Dizziness or vertigo
  • Extreme fatigue
  • Fainting or syncope
  • Loss of muscle strength
  • Respiratory depression
  • Slow heart rate, or bradycardia

Treatment Options for Opioid Abuse & Addiction

There are several options for people suffering from opioid addiction. These include:

  • Medication-Assisted Therapy (MAT) There are three medications approved to treat opioid use disorder: buprenorphine, methadone, and naltrexone. Buprenorphine and methadone can help you manage withdrawal symptoms throughout the detoxification process. Naltrexone is less commonly used, but it blocks your opioid receptors, making it impossible to get high. Medication-assisted therapy is most effective when combined with other forms of treatment.
  • Inpatient Programs — Inpatient programs are the most intensive and effective treatment options for opioid addiction. These programs guide you through medically supervised detoxification, then behavioral therapy and other services (possibly including MAT), will be added to your treatment. They typically last 30, 60, or 90 days, however they may be longer if necessary.
  • Partial Hospitalization Programs (PHPs) PHPs are also known as intensive outpatient programs (IOPs). They are the next most intensive type of treatment for opioid addiction. They provide similar services to inpatient programs such as detoxification, behavioral therapy medical services, and custom treatments such as MAT. The difference is that in a PHP, the patient returns home to sleep. Some programs will include transportation and meals, but this varies by program. Partial hospitalization programs are helpful for both new patients and patients who have completed inpatient treatment and still need intensive recovery therapy.
  • Outpatient Programs Outpatient programs work best for people who have a high level of motivation to recover. They create treatment programs that work around your schedule. These programs can either be an effective treatment option for new patients or a part of an aftercare program for people who complete inpatient or partial hospitalization program.

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Resources

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Meperidine.” St. Jude Children's Research Hospital.

Meperidine.” Meperidine | Michigan Medicine.

Narcotics for Pain During Labor: Types & Side Effects.” American Pregnancy Association, 13 Oct. 2019.

Weissman, David E. “Meperidine For Pain: What's All The Fuss?” Palliative Care Network of Wisconsin.

"Prescription Opioid Overdose Death Maps." Centers for Disease Control and Prevention,

Benyamin, Ramsin et al. “Opioid complications and side effects.” Pain physician vol. 11,2 Suppl (2008): S105-20.

 

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