What is Demerol?

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

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.

Side Effects of Demerol

Hospitals and outpatient clinics do not use Demerol as often as they used to 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)
  • Other 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, and emotional disruption, and seizures.

Drug Interactions

Demerol should not be taken with monoamine oxidase inhibitors (MAOIs). MAOIs 

When opioid medication interacts with several of the other drug types listed below, dangerous side effects, or even 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?

It is not recommended for use in 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 plan from doctors and medical professionals.

Abuse & Addiction Symptoms

Psychological dependence is one of the main signs of 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 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

Demerol is more addictive than most other opioid drugs. This is because it takes effect quickly but also wears off fast, which increases a person's tolerance level and leads to dependence sooner. 

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.

Signs of addiction to Demerol include 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 longer 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

Addiction negatively impacts an individual's emotional well-being, physical health, friendships and relationships, their families, and economic well-being.

Addiction Treatment Options

Demerol addiction can be treated with both medical and behavioral therapies. However, it is a combination of these two therapies, plus lifestyle changes created through support groups and 12-step programs, that yield the most recovery success.

Medical detox safely removes the drug from the body while minimizing opioid withdrawal symptoms typically by drug replacement and reduction therapy. Patients under detox must attend either an outpatient or residential treatment program (inpatient) that includes behavioral therapies like:

  • Therapy sessions
  • Counseling 
  • Life skills training
  • Addiction education
  • Supportive care
  • Medication Assisted Treatment

However, behavioral therapies on their own are the most widely accepted forms of treatment for an opioid use disorder. Individuals in either a residential program or an outpatient program benefit from group and individual sessions. During these sessions, people learn new methods for managing stress, coping with emotions, and also develop new life skills along the way. 

Types of Therapies

There are many types of behavioral therapies. The most common ones include Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI). 

CBT helps people to alter patterns of thought that could lead to negative behaviors. CBT can help to improve self-image and change patterns of detrimental behaviors. MI is a non-confrontational and nonjudgmental form of therapy. MI focuses on helping patients acknowledge the need for change from within themselves and helps to enhance their motivation to do so. 

Individuals learn how to control their impulses, anger, and cope with potential stressors through both of these behavioral therapies.

Other Peer supported and 12-Step programs, like Narcotics Anonymous, will also aid in an individual's recovery. They also provide patients with a group of likeminded people with similar addiction experiences and goals of sobriety create substantial treatment success.

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Resources +

“Meperidine.” St. Jude Children's Research Hospital, www.stjude.org/treatment/patient-resources/caregiver-resources/medicines/a-z-list-of-medicines/meperidine.html

“Meperidine.” Meperidine | Michigan Medicine, www.uofmhealth.org/health-library/d00017a1

“Narcotics for Pain During Labor: Types & Side Effects.” American Pregnancy Association, 13 Oct. 2019, americanpregnancy.org/labor-and-birth/narcotics/

Weissman, David E. “Meperidine For Pain: What's All The Fuss?” Palliative Care Network of Wisconsin, www.mypcnow.org/fast-fact/meperidine-for-pain-whats-all-the-fuss/

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