Nov 07, 2008

Prolonged Opioid Use May Induced Constipation

Constipation is one of the most commonly reported side effects by opiate users. Whether taking opiates at therapeutic levels or abusing them, many users report sluggish bowel movements. For many, constipation is a relatively mild and temporary condition easily treated with laxatives and changes in diet, exercise and water consumption.

Prolonged use of opiates including Fentanyl, OxyContin, Methadone and Suboxone can lead to serious blockages, that can lead to serious illness or death if not addressed. Harvard Health Publications say opiates don’t have serious side effects when used correctly, as prescribed by a doctor. However, they are expected to cause constipation.

That expectation of painful symptoms is one of the top reasons people avoid or abandon opioid use. For normal bowel function, doctors recommend exercise, increased fluids and dietary modifications, including more fiber. This, however, may not be enough for opiate users and addicts.


Opiates can interfere with normal elimination by relaxing the smooth muscle in intestines and preventing them from contracting and expelling waste. With regular use of opiates, stools can become rock hard, blocking the bowels. In severe cases, bowels can rupture, leading to sepsis or death.

Blockage can cause toxins to get trapped in the body, stressing the immune system and other functions. In “The Selfish Brain,” a book by Dr. Robert L. DuPont (with contributions by Betty Ford), DuPont says opiates are sometimes used to treat diarrhea because of their propensity to slow bowel function.

Symptoms of constipation include: abdominal bloating, swelling and cramping; straining to pass stool; pain, discomfort or blood with a bowel movement; nausea; weight loss; and decreased appetite.

What to look for with bowel obstructions:

  • Severe abdominal pain
  • Vomiting
  • Vomiting fecal matter
  • Fever/chills
  • Reluctance to eat
  • Changes in responsiveness

The U.S. Food and Drug Administration approved a new drug in April to help restore bowel function in those on long-term opiates. Relistor (methylnaltrexone bromide) is an injectable medication for opioid induced constipation.


Constipation and the resulting abdominal pain can cause addicts to take more painkillers to quell the pain. This merry-go-round of use further complicates both the addiction and the constipation.

Because addicts tend to neglect their health anyway, many choose to ignore the pain and warning signs of serious health problems. Addicts also tend not to eat balanced diets or drink enough water – which also worsens the problem.

Many opiate addicts report intense cravings for sugar and carbohydrates, foods that can wreak havoc on an already-sluggish system. Other addicts report eating very little, so they don’t “kill” the buzz from drugs like heroin, oxycodone and methadone. Avoiding food can also worsen severe constipation.

Chronic opiate use and abuse can cause severe gastrointestinal upset. For serious cases, medical help may be necessary.

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