The exact reasons why opioids cause itching are unclear, but there are several theories. This includes the activation of opioids in mast cells and opioid receptors in the skin. Opioids are a class of drugs used to relieve moderate to severe pain. These include prescription drugs such as morphine and oxycodone as well as illicit drugs, including heroin. opioids are usually a form of treatment for acute or chronic pain. However, side effects such as itching can limit its use in clinical settings.
Pruritus is a disturbing side effect of the neuraxial (epidural and intrathecal) opioid. Sometimes it may be less pleasant than the pain itself. Prevention and treatment remain a challenge. Various therapies have been used to prevent and treat opioid-induced pruritus, with mixed effects.
Why does opioid use cause itching?
Opioids such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine, and morphine are essential medications for the treatment of moderate to severe pain. However, they can cause serious side effects, such as bites, even when a person takes them as prescribed.
Itching is very common in people who use opioids. Another 2021 study found that between 60-90% of people developed itching following the use of lipophilic opioids, such as fentanyl. After morphine use, 60–85% develop itching as a side effect. Opioids cause itching because they can trigger an immune response that affects receptor proteins on the surface of the mast cells.
Mast cells are a type of white blood cell found in connective tissue all over the body, especially the skin and nerves. These cells help the immune system to respond to viruses, such as viruses and parasites, and to control other immune responses.
Many cells contain chemicals, such as histamine and cytokines, which they release during allergies and other immune responses. This helps the body expand blood vessels, allowing more blood to be absorbed. However, this can also cause itching and swelling. It seems that when people use opioids, their mast cells may respond as if they were an immune response.
A person may also feel itchy because of the effects of opioids on the nervous system. The itch sensation can spread from the skin to the brain through nerves due to opioids that interact with skin receptors.
A third possible form of the bite is injecting drugs, which may include illegal opiates such as heroin. The injection process can lead to bruises, abscesses, and skin diseases at the injection site, which may bite when they heal. The person may also pick up their skin, which can exacerbate the infection and itch.
Treatment and management of itching from opioid use
Opioids affect people differently, and some people may have a stronger immune response than others. If a person is taking prescription opioid medications and has severe itching, they should consult their doctor to discuss other options. Your doctor may prescribe anti-inflammatory drugs such as antihistamines or topical steroids to help with symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be helpful. Additionally, a physician may prescribe antidepressants to help relieve stress if this is a contributing factor.
Other side effects of opioid use
In addition to the potential for opioid overdose and increased risk of opioid use disorder with long-term use, opioid use has a range of negative side effects, which most people experience. The side effects vary from mild to life threatening and may include:
- Fecal impaction
- Dry mouth
- Irregular breathing
- Falls and accidents
- Bowel obstruction
Common treatment of opioids use disorder
There are various ways to treat opioid use disorders and control withdrawal symptoms. However, the most important step in recovery is to seek the help of a qualified healthcare professional, such as a physician, psychiatrist, psychiatrist, or nurse who can integrate an individualized treatment plan.
The most common treatment is medication. These effective medications may include methadone, buprenorphine, or naltrexone to help people reduce or stop their opioid use while controlling any associated withdrawal symptoms.
Physicians combine these medications with counseling and behavioral therapy. Counseling plays an important role in recovery and helps people deal with personal and social problems and other issues that may be contributing to their opioid use disorders. Like any other drug use problem, breaking the opioid use cycle can be difficult. However, with thorough care that covers all aspects of one’s life, recovery is possible.
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