One more reason opiates/narcotics can be dangerous for Migraineurs: they leave residual glutamate in the neuronal synapses, which may render other therapies ineffective.
Glutamate is the working end of MSG and is an excitatory neurotransmitter which can be a potent Migraine trigger. It has been placed at the top of a cascade that too often results in Migraine attacks. Examples of these drugs include Tylenol 3, morphine, hydrocodone, oxycodone, Oxycontin, Dilaudid etc. Here is a Migraine.com post I wrote some time ago re: glutamate and how it works in our brains, as well as a list of other names this nasty little neurotransmitter can hide under in our food, cosmetics and other products. We need a balanced amount of glutamate to live, but keeping that balance is tricky indeed.
Anything that potentially renders our other therapies ineffective should be avoided if at all possible.
It's sad, but many Migraineurs, especially those that are chronic, tend to think that their doctors refuse to prescribe opiates and narcotics for their Migraine pain because they don't believe how bad the pain is. Please understand - this is untrue and those who perpetuate this lie are not helping patients get better!!
Silver Creek Falls, Oregon Photo copyright 2011 Ellen Schnakenberg The truth is, having Migraine is bad enough, but can you imagine if it got worse? That is what opiates/narcotics can do for us. Yes, it helps the pain temporarily, but the damage it can cause can be long-lasting. If it help an episodic Migraineur transform into a chronic situation, so much the worse. As an advocate, I do believe there are times when treatment with opiates and narcotics are appropriate. This should be a last option however, not a first or second line drug to help with attacks. If you suffer episodic Migraine or chronic Migraine, please talk to your doctor if you are still using opiates or narcotics. These medicines are designed to help us feel better, but they do nothing to get to the root of the problem which is the Migraine process itself. It's true, we want relief from the pain, but that's only the tip of the iceberg. We don't need pain relief, we need something to abort the process or prevent it in the first place.
best life, Ellen
Schnakenberg ~patient educator and advocate