Demerol Uses, Side Effects, and Risk of Addiction

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Demerol, also known as meperidine, is one of the more well-known opioids.¹ It is prescribed for the treatment of moderate to severe pain, especially pain that does not respond well to other opioids.

Demerol’s pain-relieving effects have a more rapid onset than other opioids,¹making it a more appealing option for those patients who need immediate pain relief. Demerol can be taken as a syrup or in tablet form.²  It can also be given subcutaneously, intravenously or intramuscularly; however,  since 2003, when the World Health Organization removed it from their list of essential medications due to the potential to cause neurotoxicity or tremors, it is no longer a front-line treatment for pain.

As well, Demerol is available only under the Opioid Analgesic Risk Evaluation and Mitigation Strategy program.

What is Demerol Used For?

Demerol is a potent synthetic opioid that is classified by the Drug Enforcement Administration as a Schedule II controlled substance. Schedule II substances are known to have a high potential for abuse, addiction and physical dependence. It works by blocking pain signals in the body.

Demerol may be used for:

• Post- operative medication to reduce shivering²
• Pain management during labor³
• Severe acute pain management, especially when other pain medications are not helpful.
• Pre-operatively, to help ease anxiety and pain

Demerol is commonly used in medical settings, as it causes less respiratory depression than other opioid medications. However, even with a diminished risk of respiratory depression, it is still a potent drug with a potential for life-threatening outcomes.

Demerol Side Effects

Although Demorol was once a widely used opioid. However, because of its potential for neurotoxicity, it is being used less frequently as there are much safer alternatives.

Demerol side effects may include:

• Drowsiness⁶
• Nausea⁷
• Vomiting⁷
• Heart problems⁸
• Kidney problems ⁹
• Seizures¹⁰
• Addiction¹¹
• Overdose¹²
• Death¹²

Drowsiness

Drowsiness is a known side effect of most opioid medications.⁶ It is usually mild and not normally a cause for concern; however, if you are experiencing an unusual amount of drowsiness, please speak with your medical provider. A simple adjustment in medication dosage may be all that is needed to limit this side effect.

Heart Problems

Heart problems are a rare but serious side effect of Demerol. Heart problems have been noted among both people with and without existing heart conditions.

QT prolongation is the heart condition most often seen in those taking Demerol, which, if left untreated, could lead to death. Although heart problems have been seen in those without underlying heart disease, QT prolongation occurs most often in people with pre-existing heart conditions.

If you or a loved one is considering Demerol or is currently taking Demerol, please be certain that your medical professional is aware of any possible underlying heart conditions that you may have. Several other pain management options are available to take safely with a heart condition.⁸

Kidney Failure

Another possible risk factor with the use of Demerol is the patient’s age. Older adults appear to be more sensitive to Demerol side effects, with possible renal failure being the most significant of those side effects. Renal failure, or kidney failure, can impact the patient’s overall health and wellness and decrease their quality and quantity of life.⁹ There are limited treatment options for renal failure, so being proactive is the best method to avoid this side effect.

Seizures

Seizures have occurred in some patients taking Demerol. Because Demerol use carries a risk of seizure activity, providers should always be cautious before prescribing Demerol to patients with a medical history that may increase the risk of this rare side effect. More research is being done into the possible connection between seizures and Demerol, but at this time, the risk appears to be small.¹⁰

Effects of Demerol on Pregnant Women

Demerol is not considered a safe medication option during pregnancy, but is often used as a pain relief option, in epidural form, for women during labor and delivery. For those women who are delivering with an uncomplicated pregnancy between 37 and 42 weeks, Demerol proves highly effective in relieving labor pains.

Some possible side effects of Demerol use during labor may include drowsiness, nausea and vomiting. These side effects are not experienced by all women and are generally mild and easily managed if they are experienced.⁷It should also be emphasized that Demerol appears to be safe for newborns when taken by the mother during labor and delivery.¹³

For those patients who are choosing to breastfeed their infants, Demerol should be avoided. Demerol passes into the mother’s breast milk in high amounts, leading to potentially serious side effects for newborns and infants.

Possible newborn side effects include:

• Excessive drowsiness
• Central nervous system depression
• Difficulty breathing
• Difficulty feeding
• Limpness
• Death

Demerol Addiction

Demerol is an opioid, and because of this, it carries with it a risk of addiction.  Studies have shown that Demerol is less potent than morphine in terms of physical dependence, but because Demerol is faster-acting than other opioids, the addiction risk remains strong.

Taking Demerol in 600 mg to 800 mg daily doses greatly increases the risk of both physical and psychological addiction to the medication. Yet, several doctors argue that Demerol is a safer option for those at risk of drug dependence and/or addiction because its level of physical dependency is far less than that of others in the opioid family. ¹¹

For those who may develop a dependence on Demerol, it is highly advisable to seek professional guidance and support to overcome the developing addiction.

Call 800-934-1582(Sponsored) to discuss your rehab options and get help.

Demerol Overdose

Overdose is a very serious risk for those who have developed a physical dependence on Demerol. As Demerol is an opioid, it is not uncommon for the body to develop a physical tolerance to the medication.

When this occurs, you may need to increase the amount of medication you take to achieve the same level of euphoria as you were experiencing before.  From this point, a Demerol overdose is a great risk, as you may consume more medication than the body can process to achieve the desired euphoric effect or “high.”¹⁴

Provisional data from the Centers for Disease Control and Prevention estimate that in 2024, an estimated 47,735 people died from an opioid overdose in the United States.  For this reason, opioids such as Demerol should never be used without close medical supervision.

Demerol Withdrawal

Individuals with a dependence on Demerol may face withdrawal symptoms when they try to stop. Some of the most common withdrawal symptoms include:

• Restlessness
• Vomiting
• Diarrhea
• Sweating
• Runny nose
• Tearfulness
• Insomnia
• Achiness
• Hot and cold flashes
• Stomach cramps
• Nervousness
• Irritability
• Muscle twitches

These withdrawal symptoms can be extremely uncomfortable but are most often not life-threatening. The severity of withdrawal symptoms is dose-dependent, with those taking a larger amount of Demerol or who have used the drug for long periods experiencing more severe withdrawal symptoms.¹¹

If you or a loved one is preparing to detox from Demerol, it is important to seek medical guidance before stopping.  Professional care can help ensure a safer, more comfortable withdrawal process.  There is a range of treatment options available to support recovery from Demerol addiction.

If you or someone you know is concerned about Demerol safety or misuse, please call 800-934-1582(Sponsored) anytime and get started on a path toward sobriety.

References

1. Ching Wong, S.S., & Cheung, C.W. (2020). Analgesic efficacy and adverse effects of meperidine in managing postoperative or labor pain: A narrative review of randomized controlled trials. Pain Physician, 23(2):175-201.
2. Yasaei, R., Rosani, A., & Saadabadi, A. (2021). Meperidine. StatPearls.
3. Lee, H., & Kim, J.H. (2009). Superiority of split dose midazolam as conscious sedation for outpatient colonoscopy. World J Gastroenterol, 15(30):3783-7.
4. Sensoy, E., Akcan, A.C., Korkmaz, M., Elmalı, F., Topal, U., Akgun, H., & Muhtaroglu, S. (2020). Investigation of the effects of systemic meperidine administration on fascia healing in an experimental rat model. Acta Cir Bras, 35(11):e351107.
5. Tainter, M., & Buchanan, O. (1949). A comparison of certain actions of Demerol and methadone. Calif Med, 70(1):35-43. PMID: 18104720; PMCID.
6. Benyamin, R., Trescot, A.M., Datta, S., Buenaventura, R., Adlaka, R., Sehgal, N., Glaser, S.E., & Vallejo, R. (2008). Opioid complications and side effects. Pain Physician, 11(2).
7. Drugs and Lactation Database (LactMed). (2006). National Library of Medicine (US), 4(20).
8. Song, M.K., Bae, E.J., Baek, J.S., Kwon, B.S., Kim, G.B., Noh, C.I., Choi, J.Y., & Park, S.S. (2011). QT prolongation and life-threatening ventricular tachycardia in a patient injected with intravenous meperidine (Demerol®). Korean Circ J., 41(6):342-5.
9. Friesen, K.J., Falk, J., & Bugden, S. (2016). The safety of meperidine prescribing in older adults: A longitudinal population-based study. BMC Geriatr, 16(100). d
10. Schlick, K.H., Hemmen, T.M., & Lyden, P.D. (2015). Seizures and meperidine: Overstated and underutilized. Ther Hypothermia Temp Manag, 5(4):223-7.
11. Himmelsbach, K. (1943). Further studies of the addiction liability of Demerol (1-methyl-4-phenyl-piperidine-4-carbodxylic acid ethyl ester hydrochloride). United States Health Service Hospital, 4(28).
12. Dydyk, A.M., Sizemore, D.C., Haddad, L.M., Lindsay, L., & Porter, B.R. (2021). NP safe prescribing of controlled substances while avoiding drug diversion. StatPearls.
13. Smith, L.A., Burns, E., & Cuthbert, A. (2018). Parenteral opioids for maternal pain management in labour. Cochrane Database, 6(6).
14. Mercadante, S., Arcuri, E., & Santoni, A. Opioid-induced tolerance and hyperalgesia. (2019). CNS Drugs, 33(10):943-955. d

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