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Semantics: narcotics vs. opioids
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How do you refer to pain medications? Do you use "opioid" or "narcotic?" I prefer the former, since I think the latter has a negative, illegal feel to it. If you look up the definitions in a dictionary, you see this:
"nar·cot·ic [nahr-kot-ik] any of a class of substances that blunt the senses, as opium, morphine, belladonna, and alcohol, that in large quantities produce euphoria, stupor, or coma, that when used constantly can cause habituation or addiction, and that are used in medicine to relieve pain, cause sedation, and induce sleep."
How about for opioid?
"o·pi·oid [oh-pee-oid] 1. any opiumlike substance, 2. any of a group of natural substances, as the endorphins, produced by the body in increased amounts in response to stress and pain. 3. any of several synthetic compounds, as methadone, having effects similar to natural opium alkaloids and their derivatives."
Another site I found stated that narcotics are types of pain medicines, including opiates (from the poppy plant) and opioids (derivatives of opiates). It sounds like both would apply to the class of pain medicines we routinely prescribe for our cancer patients, and it also sounds like illegal things like heroin could also technically be described with either word, so what is an oncologist to do?
Maybe it has to do with the ridiculous number of episodes of "Cops" that my husband has forced me to watch over the years, that I have narcotics = illegal in my head. When I do a Medline search, it looks like most of the scientific literature on the topic uses "opioid" in their titles and manuscripts, but you can search by either term and get largely the same search results. An excellent blog by a palliative medicine doc echoes what I believe when he says "'Narcotics' is primarily a law enforcement term, 'opioids' are a class of medications."
In an earlier post, he said it more strongly: "Narcotic is primarily a legal term referring to controlled substances regulated by the DEA, thus the Narcotics division, the 'narc' informant, etc. Narcotics, when using the original definition, really applies to a medication with an effect of sleepiness or stupor. Therefore it is way too broad of a definition to include just opioids. Say 'opioids' when you discuss it in medical terms, say 'narcotics' when you are discussing legal/regulatory issues."
So, what is your preferred lingo? Do you perceive a stigma from using the word "narcotic" or is it in my head?