Short-acting opiates: what are they?
Classification by speed of action
In specialist medicine (as in pain therapy), short-acting opioids are divided into two categories:
- SAO (short-acting opioids): These non-retard medications (for example drops or normal tablets) take effect after about 30 minutes and usually last 4 to 6 hours. They are often used to find the right dose.
- ROO (rapid-onset opioids): These ultra-short-acting preparations (often fentanyl nasal sprays or melt tablets) take effect after only 5 to 10 minutes, but the effect wears off again after 1 to 2 hours. They are used specifically for sudden, severe pain peaks (so-called breakthrough pain).
>> Why it is still not suitable for preparation: because it is so extremely strong, you can no longer dose it as small as you need it before the treatment. Heroin actually also counts as a short-acting opiate. Even if its strength depends on the quality, contamination is the biggest danger here.
Typical examples in Germany and Austria
The active substances themselves are divided into weak and strong, but in the "short-acting version" they always come in a fast-release form (drops, capsules, injections):
| Active substance | Strength | Typical short-acting form |
|---|---|---|
| Tilidine / tramadol | weak | drops or non-retard capsules |
| Morphine | strong | non-retard tablets (for example MSI) or ampoules |
| Oxycodone | strong | acute capsules (non-retard) |
| Fentanyl | extremely strong | nasal spray, lollipop or tablets |
Risks: why short-acting opiates are closely monitored
Because of the fast onset of action ("flooding" in the brain), non-retard, short-acting opioids carry a much higher risk of psychological dependence and abuse than long-acting patches or retard tablets. Incorrect use or overdose can cause dangerous side effects such as severe respiratory depression (danger to life). They are therefore subject to strict narcotics regulations and should only be taken exactly as instructed by a doctor.