Author: Susanne Reed, PhD

Demerol is an opioid prescription medicine classified as a Schedule 2 narcotic. It is similar to morphine in its properties and has a high potential for addiction.¹ While Demerol is typically prescribed in a hospital setting, it has become a drug misused for non-medical purposes. In addition to being highly addictive, Demerol can cause severe side effects.¹

In This Article:

• About Demerol
• Demerol Side Effects
• Risks of Demerol Misuse
• Demerol Dependence and Addiction
• Demerol Withdrawal and Overdose Risks
• Treatment for Demerol Addiction

About Demerol

Demerol is the brand name for the generic drug meperidine. Historically, Demerol was once the most commonly prescribed drug to treat pain following surgery. However, due to its limited pain relief and high toxicity, Demerol was replaced by newer opioids introduced in the 1990s, such as hydrocodone and oxycodone.²

Today, use of Demerol is generally limited to treating postoperative shivering and drug-induced tremors.³ It may also be used for short-term pain management in individuals who cannot tolerate other opioids.³ In no cases should Demerol be used to treat chronic pain.²

Demerol Side Effects

Demerol produces more severe side effects than newer opioids because of how the drug is metabolized in the body. The liver converts some of the drug to a potentially toxic metabolite called normeperidine that accumulates in the body.³

Side effects caused by using Demerol for just several days may include tremors, delirium, seizures, nervousness, muscle twitching, and altered mental state.^4,5 Demerol also causes more respiratory depression and sedation than other opioid medications.³

Other Demerol side effects can include:⁶

• Chest pain
• Difficulty breathing
• Cardiac arrest
• Coma
• Rapid or unstable heart rate
• Vomiting
• Constipation
• Nausea
• Nervousness
• Sleepiness
• Dizziness or faintness
• Depression
• Brain fog

Because of how the liver processes this medication, Demerol side effects can be more severe than from other opioid drugs.³ If you experience any severe side effects from taking Demerol, discontinue use and call 911 for emergency assistance.

Taking this drug with alcohol is especially dangerous and can lead to life-threatening Demerol side effects. Mixing Demerol with alcohol can suppress your respiratory system to the point that you stop breathing. This is because both drugs are depressants.⁵

Demerol can also interact with medications such as benzodiazepine drugs (used to treat anxiety and sleep disorders) and cause more severe side effects. Taking Demerol with certain anti-depressants, such as selective serotonin reuptake inhibitors (SSRIs), can lead to serotonin syndrome, which can be fatal.⁵

Risks of Demerol Misuse

Misuse of this medication can increase Demerol side effects. Misuse occurs when you take a medication in larger or more frequent doses than prescribed. Or you may alter its form to produce stronger effects, such as by crushing it to snort it or liquifying it for injection into the bloodstream.⁵

Misusing Demerol may lead to:^5,7

• Slow heart rate
• Slow breaths or breathing that stops
• Severe drowsiness, dizziness, or confusion
• Mood swings
• Digestive problems
• Tremors or muscle spasms
• Seizures
• Overdose
• Coma
• Death

Demerol Dependence and Addiction

Even when taken as prescribed, you can develop dependence on opioid drugs such as Demerol.⁸ Dependence develops as your tolerance to a medication increases. This means you need to take more of the drug to achieve the same pain-relieving or euphoric effects you experienced when you first took it. You can identify Demerol dependence when you start to feel withdrawal symptoms after several hours of stopping your dosing.⁹

Painful withdrawal symptoms can create strong motivation to use Demerol again to relieve the discomfort. If your dependence on Demerol leads you to spend a lot of your time seeking and using drugs to function, this is a sign of addiction. Other signs of addiction to Demerol include:⁸

• Increasing the amount or frequency of Demerol use
• Not being able to stop using Demerol
• Experiencing extreme cravings and urges for Demerol
• Seeking the drug through illegal methods
• Continuing to use Demerol even though it is interfering with work, home, or relationships
• Participating in risky behaviors to obtain the drug
• Skipping important events to use the drug
• Neglecting responsibilities because of Demerol use

As your dependence or addiction to Demerol grows, your withdrawal symptoms will worsen, and your chances of overdose increase.⁹

Demerol Withdrawal and Overdose Risks

Withdrawing from Demerol can be painful and include symptoms like those produced by other opioids including:

• Sweating
• Nausea, vomiting, digestive problems
• Mood swings
• Anxiety, depression, or an increase in mental health issues
• Tremors, seizures, spasms
• Hallucinations, paranoia

To avoid these withdrawal symptoms, you may want to take any dose of Demerol or another opioid, but doing so can lead to adverse effects, including overdose. This is especially true after discontinuing opioid use because your drug tolerance quickly declines and you become more sensitive to the drug’s effects.

Signs of Demerol overdose include:^5,7

• Difficulty breathing
• Irregular heartbeat
• Seizures
• Coma or slipping in and out of consciousness
• Lethargy
• Changes in skin color
• Vomiting or making gurgling noises
• Limp body
• Cardiac arrest

If you suspect someone using Demerol is overdosing, call 911 for emergency medical assistance. Wait with them until the professionals arrive. Turn a person overdosing onto their side to avoid choking on vomit. If there are no signs of breathing or a pulse, you can perform CPR. The 911 operator can give you instructions over the phone. Administer naloxone if it is available.¹⁰

Naloxone is a medication that can be used to reverse opioid overdose effects and restore normal breathing. It can be purchased over-the-counter as a nasal spray in some states.¹¹ You also may be able to obtain a prescription for naloxone from your primary care doctor. Be sure you or other members of your household know how to properly administer naloxone. Naloxone only works for opioid overdose and does not last long in the body’s system, so it’s crucial to get medical help for the person overdosing on Demerol.¹¹

Treatment for Demerol Addiction

If you or someone you know experiences an overdose, entering addiction treatment can help one avoid further complications of using Demerol.

Demerol addiction treatment is a process that can take weeks or months to complete. The more time you spend in treatment, the less likely you are to relapse. Typical steps of treatment that work for many people are as follows:¹²

Detox

Detoxification from Demerol in a hospital or rehab center provides around-the-clock medical attention. Clinicians can provide you medication to ease withdrawal symptoms like cravings and physical discomfort. The goal of detox is to clear your mind and body of the toxins associated with Demerol. Detox can last about a week, depending on your needs. After detox, the next phase of treatment takes place in inpatient rehab.

Inpatient Rehab

At this stage, you continue your stay in a medically supervised inpatient environment. Medical specialists will manage your withdrawal symptoms and assess your need to be treated for other physical or mental health issues.

Therapies like cognitive behavioral therapy, motivational interviewing, and dialectical behavioral therapy can help you develop new skills and ways of thinking to help you succeed in recovery. Inpatient rehab can last from 30 to 90 days. Upon completion of inpatient rehab, you can transition to a sober living environment.¹²

Sober Living

Sober living homes or halfway houses offer you a chance to practice implementing the tools learned during inpatient treatment. You won’t live in a hospital environment, but you will have roommates new in recovery, just like you. You can get a job, attend community support groups, continue medical and mental health treatments, and incorporate structure into your routine. After you decide you are ready to leave sober living, you can begin intensive outpatient counseling.¹²

Intensive Outpatient Counseling

Once back into your home environment, you are no longer isolated from triggers and stressors that lead to relapse. Now you need more support than ever before. Intensive outpatient care allows you to attend both group and individual therapies throughout the week, for 10 or more hours, until you feel confident in your recovery. Then, you can continue individual counseling.¹²

Ongoing care in recovery is important for lasting sobriety. Attending 12-step or other recovery support meetings is a proven way to maintain ongoing success in recovery.¹⁴

Some of the stages and settings of treatment described above may vary, depending on individual needs.

If you have been using or misusing Demerol, now is the time to seek help. Call 800-934-1582(Who Answers?) to speak with a treatment specialist about addiction recovery options.

Resources:

1. U.S. Food and Drug Administration. Demerol.
2. Weissman, D. (2015). Meperidine for Pain: What’s All The Fuss? Palliative Care Network of Wisconsin.
3. Dobbins, E. (2010). Where has all the meperidine gone? Nursing, 40(1), 65-66.
4. S. Food and Drug Administration. (2010). Demerol® (meperidine hydrochloride, USP).
5. Medscape. Meperidine (Rx).
6. U.S. National Library of Medicine. (2021). Meperidine. Medline Plus.
7. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
8. Kosten, T.R. & George, T.P. (2002). The Neurobiology of Opioid Dependence: Implications for Treatment. Addiction Science & Clinical Practice. 1(1): 13-20.
9. S. National Library of Medicine. (2021). Opiate and opioid withdrawal. Medline Plus.
10. National Institute on Drug Abuse. (2019). Naloxone DrugFacts.
11. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Types of Treatment Programs
12. Stotts, A. L., Dodrill, C. L., & Kosten, T. R. (2009). Opioid dependence treatment: options in pharmacotherapy. Expert opinion on pharmacotherapy, 10(11), 1727–1740.