Side effects are frequently seen with the use of narcotics. Some of these side effects are characteristics of the narcotic agents.
a. Dependence. Dependence is a side effect of narcotics, which has caused much concern among many health-care professionals. There are two types of dependence.
(1) Psychological. Psychological dependence is produced when the drug causes an emotional or mental desire to repeat the use of the drug. Consequently, the individual taking the drug has a craving for the pleasurable mental effects produced by the drug (that is, euphoria, and so forth).
(2) Physiological (physical). Physical dependence is produced by prolonged use of a drug whose pharmacological action causes the body to adapt to its presence. When the drug is withdrawn after the person has become physically dependent, the body of the individual reacts in a hyperexcited way. You have probably read about or seen heroin (narcotic) addicts who are undergoing withdrawal. These episodes of withdrawal are characterized by stimulation of the central nervous system.
b. Tolerance. Tolerance is the body's ability to adapt to the presence of a foreign chemical substance (drug). This results in the requirement for progressively larger doses of the drug in order to obtain the same effect in the patient. It should be noted that tolerance is frequently seen in patients who abuse narcotics. Tolerance is not of great concern in narcotic therapy of short duration. However, for those chronically ill patients who are on long-term narcotic therapy, increased doses of the narcotic agents might be indicated to maintain the desired level of analgesia.
c. Drowsiness. Drowsiness is another side effect of narcotics. For this reason, individuals who are receiving narcotics should seriously examine their activities that is, driving) for safety purposes.
d. Miosis. Miosis (constricted pupils) is an effect commonly known as "pinpoint" pupils. Miosis is commonly seen in patients who are taking narcotic agents.
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