What is Demerol and Was it Taken Off the Market?

What Is Demerol?

Otherwise known as meperidine, Demerol is a prescription drug used to treat the symptoms of moderate to severe or chronic pain by injection, or it can be taken orally. Demerol may be prescribed to be used with other medications or alone by doctors. Specifically, it belongs to a class of drugs called opioids, opioid analgesics, and synthetic opioids.

How Does It Work?

Like other opioids, Demerol (meperidine) works by activating opioid receptors on nerve cells in the brain, spinal cord, stomach, and other areas of the body. When this happens, the opioids block pain signals from the body to the brain, effectively alleviating the person’s symptoms. However, if you haven’t heard of the opioid epidemic, then you may not know the risks associated with drugs like Demerol.

Not only can Demerol alleviate pain, but it can also produce a rush of euphoria or a “high.” When drugs stimulate mu-opioid receptors in the central nervous system, cells in the ventral tegmental area (VTA) produce and release dopamine into the nucleus accumbens. The VTA is a group of neurons located near the midline floor of the midbrain, so basically at the top of your spinal cord. The nucleus accumbens is located near the VTA.

Both the VTA and nucleus accumbens play a significant role in reward, motivation, cognition, action, and aversion. The nucleus accumbens is also well-known in the field of addiction for its key role in behaviors associated with eating, sex, reward, stress, and substance abuse. In other words, when you take Demerol, pain signaling is blocked while the VTA and nucleus accumbens release dopamine into the central nervous system.

Demerol Side Effects

Common side effects of Demerol (meperidine) include:

• Lightheadedness
• Dizziness
• Sedation
• Euphoria
• Weak or shallow breathing
• Stopped breathing while sleeping
• Confusion
• Tremors or shaking
• Seizure (convulsions)
• Mood swings
• Nausea and/or vomiting
• Loss of appetite
• Dry mouth
• Weakness
• Fatigue
• Difficulty urinating
• Decreased sexual libido
• Constipation

You shouldn’t use Demerol if you have asthma, breathing problems, or a blockage in your stomach or intestines. Because opioids are considered sedatives or depressants, they’re known for slowing down nerve activity and physiological functions like heart rate and breathing.

It’s also important to keep in mind that Demerol is addictive, meaning that abusing it can lead to increased tolerance, physical dependence, addiction, and withdrawals when use is stopped or reduced. Abusing meperidine includes taking more than the recommended dose, taking it more frequently than directed, and mixing it with other drugs or alcohol.

Demerol addiction can occur in anyone, even in those who take it as prescribed. Long-term abuse can impact the brain, heart, and other organs of the body. If you want to quit and need help, receiving medical opioid detox is the safest way to overcome withdrawals.

Why Was Demerol Taken Off the Market?

Demerol was actually never taken off the market. Instead, a similar drug called propoxyphene was taken off the market because it increased the risk of suicide and fatal overdoses in the United Kingdom and for arrhythmias in the United States.

So, is Demerol still prescribed? Yes. However, doctors feel just as strongly about banning meperidine. Because meperidine causes less hypotension (low blood pressure), respiratory depression, urine retention, and stomach problems than morphine, it was a popular drug in the past. However, as technology advanced, more problems were discovered with Demerol’s use.

Specifically, Demerol is dangerous because of the way it’s metabolized in the liver, where some of it is converted into normeperidine. Normeperidine can cause an altered mental state, nervousness, anxiety, seizures, delirium, psychosis, and muscle twitching. Because the kidneys excrete it, patients with kidney problems are at higher risk of toxicity or overdose.

Demerol also blocks the reuptake or reabsorption of neurotransmitters serotonin and norepinephrine, contributing to serotonin syndrome. This potentially fatal condition is most common in people who take specific kinds of antidepressants, such as monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants.¹

Today, although Demerol is still taken, it’s only prescribed in special cases, with strict limitations on dosing. For instance, patients should receive no more than 600 milligrams (MG) for no more than two days. Adults with kidney problems should also be prescribed lower doses.¹