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Narcotic (Opioid) Pain Medicine for Chronic Pelvic Pain

Experts disagree about the use of narcotics (opioids), such as codeine, meperidine, morphine, or oxycodone, for the treatment of severe chronic female pelvic pain.1

Some experts think that the use of opioid pain medicine should be avoided. They cite the muscle-relaxing effect of these medicines, which may make some causes of pelvic pain worse. They also think that the sedating effects of opioids alter the normal thought process and further limit participation in daily activities. Some women with chronic pelvic pain also are at high risk for problems with substance abuse and addiction.

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Other experts think that severe pain that does not respond to other medicines should be treated with opioids. They think that brief use of opioids is generally well-tolerated and does not present a significant potential for abuse. These experts think that undertreatment of pain is more likely to lead to problems with chronic pain, drug abuse, and addiction. They think that early, aggressive, and time-limited treatment with an opioid is an effective method of treating pelvic pain.

Longer-term treatment with an opioid is sometimes used to treat severe chronic pain. If your doctor suggests this approach, discuss the risks. And think about getting a second opinion from a pain treatment specialist.

When given to treat unmanageable pelvic pain, an opioid is used on a regular schedule rather than on an "as needed" basis. Many doctors require a signed, written contract for responsible use before prescribing an opioid.

Citations

  1. American College of Obstetricians and Gynecologists (2004, reaffirmed 2008). Chronic pelvic pain. ACOG Practice Bulletin No. 51. Obstetrics and Gynecology, 103(3): 589-605.

By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer Kirtly Jones, MD - Obstetrics and Gynecology
Last Revised January 11, 2011

WebMD Medical Reference from Healthwise

Last Updated: January 11, 2011
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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