Meperidine (Demerol) Addiction and Withdrawal

According to the U.S. National Library of Medicine, meperidine is the generic name for a medication typically marketed under the brand name Demerol. The Food and Drug Administration (FDA) describes Demerol as a narcotic drug that acts similarly to morphine to relieve pain. Doctors prescribe Demerol to treat moderate to severe pain.

While Demerol is a prescription drug and can be useful and safe for some people, there is a potential for some individuals to abuse this medication and experience serious consequences. In some cases, people may need treatment to stop using Demerol.

What is Demerol?

As previously stated, Demerol is a pain medication. It belongs to a category of drugs called opioids and is available in the form of a tablet as well as in a liquid syrup.

According to experts writing for BMC Geriatrics, Demerol’s pain-relieving effects take place quickly, but they only last for 2.5 to 3.5 hours. This means that compared to other opiate pain relievers like morphine, Demerol may not be as beneficial for reducing pain.

Demerol Uses

Demerol is a pain medication, but its current uses may be rather limited. According to the professional journal Nursing, Demerol was once the most popular opioid pain reliever, but since 1990, most experts have advised against its use as a pain reliever, because there have been numerous reports of dangers and adverse reactions associated with the drug.

Given the potential danger of Demerol, doctors currently use it to treat shivering after surgery, and drug-related tremors. It may also be used over the short-term to treat pain in patients who are not able to tolerate other opioid medications. Per the report in Nursing, when doctors use Demerol, they should limit daily doses to no more than 600 mg and should not give the drug for more than two consecutive days. The FDA also warns that Demerol should be used only to alleviate short-term pain, as it is not appropriate for treating chronic pain.

Side Effects of Demerol

Demerol is a prescription drug with legitimate medical uses, but that does not mean it is free from side effects. Per the FDA, the most common side effects associated with Demerol use are the following:

Lightheadedness and Dizziness
Sedation
Sweating
Nausea and Vomiting

Other potential adverse reactions to Demerol, while not as common, can include:

Bad Mood
Weakness
Headaches
Tremor
Lack of Coordination
Hallucinations
Dry Mouth
Constipation
Low or High Heart Rate
Facial Flushing
Heart Palpitations
Rashes

Another problem associated with Demerol, according to a report in BMC Geriatrics, is the fact that the body metabolizes it into a chemical called normeperidine, which can be toxic to the nervous system. Since the effects of Demerol are short-lasting, people must take relatively frequent doses of the drug. This causes a buildup of normeperidine, which can lead to seizures and delirious behavior, especially among older adults. Other opioid drugs are often preferred, given the toxic nature of normeperidine.

Demerol Abuse

As the FDA has explained, Demerol is an opioid drug, which means that it may be abused, just like other opioid drugs such as morphine or heroin. Demerol, as an opioid, may be attractive to drug dealers as well as those who use drugs to achieve a high. While Demerol is intended to be taken by mouth as a doctor prescribes it, people may crush the drug and snort it or dissolve it into liquid to inject it. These methods can help people to achieve a high, since opioid drugs, including Demerol, can create a euphoric effect.

Some people may abuse Demerol by purchasing it illegally from street level drug dealers or by stealing medication that does not belong to them. Others may misuse prescribed Demerol by using it other than intended, such as by snorting the drug, or by taking larger doses than a doctor prescribes. It is also possible that some people will go to multiple doctors seeking prescriptions for Demerol, so they can get additional pills. This is considered a form of Demerol abuse.

Given the potential for people to abuse this drug, the Drug Enforcement Administration classifies it as a Schedule II Controlled Substance. This category is reserved for drugs that have a high potential for abuse and are considered to be dangerous. Other opioid drugs, such as OxyContin, fentanyl, methadone, Dilaudid, and Vicodin are in this category.

Demerol Addiction

Demerol does have a potential for abuse, and people who abuse it may become addicted. This can begin with tolerance, which according to the National Institute on Drug Abuse (NIDA), can develop even if a person takes an opioid drug like Demerol as a doctor prescribes it. When the body becomes tolerant to Demerol, a person will need larger and larger doses to achieve the same pleasurable effects.

Over time, with repeated Demerol doses, a person can become dependent, meaning that the body cannot function without the presence of the drug. While drug dependence does not always lead to addiction, a person who becomes dependent upon Demerol is more likely to experience addiction. With addiction, a person will begin to use Demerol compulsively, despite serious consequences, like health issues and problems at work or home.

Addiction professionals use the term “substance use disorder” to refer to an addiction, so someone who seeks treatment for Demerol addiction may be diagnosed with such a condition. Some diagnostic symptoms of a substance use disorder involving Demerol include the following:

Signs of Demerol Addiction

Taking larger doses of Demerol than intended
Being unable to reduce Demerol use despite desiring to do so
Spending a significant amount of time obtaining or using Demerol
Demerol cravings
Ongoing Demerol use that causes problems meeting demands at work or home
Continuing to use Demerol even in the face of social problems
Using Demerol when it causes physical danger
Giving up activities due to Demerol
Using Demerol even when it causes health problems or makes them worse

The above diagnostic symptoms are included in the Diagnostic and Statistical Manual of Mental Disorders, which addiction professionals use to diagnose substance use disorders. A substance use disorder involving Demerol can range from mild, when a person meets a few diagnostic criteria, to severe, when a person meets at least six of the criteria.

Some behavioral examples of diagnostic criteria can make the signs of Demerol addiction more clear. For example, a person who continues to use Demerol in the face of social problems may have ongoing arguments with a spouse regarding drug use. Giving up activities may involve missing out on time with friends or giving up healthy habits like going to the gym. Furthermore, driving when under the influence of large amounts of Demerol could meet the criterion of using Demerol when it causes physical danger. Finally, Demerol may cause problems meeting demands at work, such as showing up on time or meeting deadlines, if someone is missing work due to being under the influence or seeking drugs.

Demerol Overdose

Beyond the risk of addiction, another serious consequence that can occur with Demerol abuse and addiction is a drug overdose. The FDA has warned that abusing this drug by injecting or snorting increases the risk of an overdose death. Furthermore, other depressant drugs, such as sedatives, anesthetics, tranquilizers, and alcohol can interact with Demerol and cause stopped breathing, coma, extreme sedation, and dangerously low blood pressure. Combining Demerol with any of these substances therefore increases the risk of fatal overdose.

According to NIDA, a prescription opioid overdose occurs when people take too large of a dose of these drugs, because large doses can cause breathing to slow or stop. The lack of oxygen from breathing problems can cause coma, brain damage, or even death.

Demerol Overdose Symptoms

Extreme Sleepiness
Cold, Clammy Skin
Muscle Paralysis
Stupor
Slow Heart Rate
Low Blood Pressure

As previously noted, Demerol overdose can ultimately lead to completely stopped breathing and death. Per the FDA, this is especially likely when someone uses the drug intravenously; this route of Demerol use can even cause cardiac arrest.

Treatment of Demerol Overdose

Demerol overdose can be deadly, but proper treatment can reduce the risk of serious consequences such as a fatal overdose. It is important that a person who has overdosed receive emergency medical care. According to NIDA, emergency medical personnel can administer a medication called naloxone, which blocks the effects of opioids and reverses an overdose.

After receiving naloxone, it is possible that a person who has experienced Demerol overdose will need to be monitored in a hospital setting. In the case of a serious or potentially fatal overdose, it is critical that breathing return to normal, so a person may require treatment with a ventilator. Additional treatments, such as IV fluids and medications to increase blood pressure, may be necessary.

Demerol Withdrawal

In addition to the risk of overdose, Demerol withdrawal is another consequence associated with abuse and addiction. When a person has abused Demerol to the extent that he or she becomes dependent upon the drug, the body will not be able to function properly in the absence of Demerol. This results in uncomfortable withdrawal symptoms.

Demerol Withdrawal Symptoms

Pain in the muscles and bones
Sleep disturbances
Gastrointestinal symptoms like nausea and vomiting
Cold flashes
Goose bumps
Intense drug cravings
Involuntary leg movements

The above symptoms are unpleasant and can make it difficult to stop using Demerol. Fortunately, these symptoms will pass. The Demerol withdrawal timeline is typically four to ten days, meaning that people can expect withdrawal symptoms to pass within a week or so. According to the World Health Organization, withdrawal from short-acting opioids begins eight to 24 hours after a person stops using drugs. Demerol is relatively short-acting, so a person who has developed a dependence can expect withdrawal symptoms to appear rather soon after the last dose of Demerol.

Demerol Withdrawal Treatment

Given the fact that Demerol withdrawal is uncomfortable, it is often necessary for people to receive help to stop using this drug. Detox programs can provide the support that people need to manage acute Demerol withdrawal. During a detox program, medical staff can monitor withdrawal symptoms and provide supportive and medical care as needed.

In a detox program, staff will often use a withdrawal scale to assess how severe a person’s Demerol withdrawal symptoms are. According to the World Health Organization, mild withdrawal typically requires a healthy diet, plenty of fluids, and management of specific symptoms as they arise. For example, medical staff may administer medications like ibuprofen to treat pain or loperamide to treat diarrhea.

If withdrawal progresses to a moderate or severe level, doctors in a detox program may prescribe one of two medications typically used to manage opioid withdrawal: buprenorphine or methadone. Both of these drugs can alleviate withdrawal symptoms and reduce Demerol cravings. In addition, NIDA has reported that the FDA recently approved a drug called lofexidine, which is a non-narcotic developed specifically to treat opioid withdrawal.

Demerol Addiction Treatment

A detox program can provide help for Demerol withdrawal and is the first step toward sobriety, since it can be difficult to manage uncomfortable Demerol withdrawal side effects. While detox is important, detox programs alone are not enough to help people stay sober from Demerol. An ongoing addiction treatment program that uses psychological and behavioral therapies is necessary to recover from Demerol abuse and addiction.

Demerol addiction treatment can occur in an inpatient setting, such as a residential treatment program, or in an outpatient clinic, in which people live at home but attend appointments in an office setting. Regardless of the type of treatment, most addiction treatment programs involve a combination of group and individual counseling. This type of treatment helps to address the underlying issues that contributed to addiction so that people can develop new ways of coping.

One particular form of counseling called cognitive behavioral therapy (CBT) can be beneficial for people receiving Demerol addiction treatment. This type of therapy helps people to change their behaviors related to drug use and develop healthier ways of managing stress. In opioid addiction treatment, counseling methods like CBT may be combined with medications, including buprenorphine or methadone. These same medications that are used in detox programs can reduce drug cravings and help people to maintain sobriety while they are in ongoing treatment. Medications and counseling seem to be particularly effective when combined, so people looking for help for Demerol addiction may see the most success when they receive both forms of treatment.

Demerol FAQs

Beyond the detailed information presented herein, the following Demerol FAQs can provide quick answers to common questions about this drug:

Is Demerol still used?

Demerol use has declined significantly since the 1990s, given the risks associated with this drug. Since Demerol is potentially toxic and has only short-lasting effects, other opioids are used in favor of Demerol unless a patient cannot tolerate them. Demerol may be used when a person cannot use other opioid drugs or when a person is experiencing shivers following surgery. It can also be used to treat drug-related tremors.

Is Demerol a narcotic?

Demerol belongs to the opioid class of drugs. Some people refer to this class as narcotics. What drugs in this class have in common is that they have analgesic, or pain-relieving effects.

Does Demerol contain codeine?

Demerol does not contain codeine; the active chemical in this drug is meperidine, which the body metabolizes into normeperidine.

Is Demerol a dangerous drug?

Demerol can be safe when a doctor prescribes it for short-term use; however, long-term used can cause a toxic chemical called normeperidine to build up in the body. Demerol can also be dangerous when abused, as it can lead to addiction and overdose. Demerol has the potential to be dangerous when people misuse it to achieve a high.

Demerol can be dangerous, despite being a prescription medication. Even when used as prescribed, people can experience negative side effects and become dependent upon the medication. Other opioid drugs seem to be preferred to Demerol, with it being the last choice for treating short-term pain when other medications are not an option.

Given the dangers of the drug, Demerol should only be taken exactly as a doctor prescribes. It is never safe to take more Demerol than prescribed or to misuse it by stealing medication, buying it illegally, or snorting or injecting the drug. Those who have been abusing Demerol and find that they are unable to stop should seek addiction treatment to avoid negative consequences of drug use.