Meperidine addiction: Signs, symptoms and side effects

Meperidine, known as Demerol in some countries and pethidine in the UK, is a synthetic opioid once widely used for pain relief in childbirth and after surgery. Its use has declined due to a toxic metabolite, normeperidine, which can be fatal. Yet, some people, particularly healthcare workers with easy access, still struggle with addiction. Understanding meperidine’s unique risks is crucial for anyone taking it to prevent addiction, permanent neurological damage or even death.

Meperidine addiction pills

What is meperidine addiction?

Meperidine addiction is a loss of control over use, even though you may want to quit or know that using is bad for you. Many people first take meperidine during childbirth, post-surgery, or while working in healthcare. Being given meperidine by a doctor can make it feel safe, but this can mask its serious addiction and health risks.

How does meperidine addiction develop?

Like all opioids, meperidine has euphoric and sedative side effects, and these make it prone to abuse. Meperidine is rarely sold on the streets and almost never prescribed for take-home use, so a lot of instances of meperidine abuse and addiction involve healthcare workers who can easily access it.

In these cases, meperidine abuse sometimes starts by taking small amounts from supplies for quick relief from a headache, migraine, or due to the stress of a difficult job. However, the short duration means relief fades fast, prompting another quick meperidine dose to keep the effects going.

The more you take meperidine, the more your brain wants it. If you keep feeding early cravings, you can develop a physical dependence, which causes withdrawal symptoms when meperidine abuse ends. These include typical opioid symptoms like sweating, vomiting, diarrhoea, muscle pain, insomnia, and anxiety, but which begin much quicker than with most opioids.

Eventually, meperidine can seem like the quickest, most effective, or only solution to everything from stress to insomnia. Once you are fully addicted, you take meperidine to avoid withdrawal, but also because it becomes an emotional coping mechanism.

Recognising meperidine addiction signs

You don’t have to buy drugs on the street to become addicted. Meperidine addiction can hide behind genuine medical use, particularly if you work in healthcare or first received it in hospital. But these meperidine addiction signs can reveal when your use has become problematic:

  • Increasing how much and how often you are using meperidine without needing any more for pain. 
  • For healthcare workers: diverting pethidine from hospital supplies, manipulating medication records, or volunteering for shifts where access is easier.
  • For former patients: fabricating pain complaints to doctors, visiting multiple A&E departments, or purchasing diverted medication.
  • Developing tremors, muscle twitches, or jerky movements you can’t control.
  • Confusion, difficulty concentrating, or periods where you can’t think clearly.
  • Dosing every few hours throughout the day and night because relief is so short-lived.
  • Isolating from colleagues, friends, or family who question your behaviour.
  • Recognising that the problems are getting worse but continuing to use meperidine.

girl suffring meperidine addiction

Why is meperidine addictive?

Meperidine activates opioid receptors, releasing dopamine for pain relief and euphoria. However, its shorter duration of 2-4 hours versus 4-6 hours for morphine means effects fade quickly, driving more frequent use. This rapid cycle accelerates dependence, but several other factors contribute to a dull meperidine opioid addiction

Working in healthcare

Being able to access meperidine easily, and just taking a small amount when you’re surrounded by medications constantly, may not feel like a big deal. Many healthcare workers start meperidine abuse during tough periods when they are short-staffed, working through personal problems or have had a traumatic experience with a patient. Soon, getting through a day or even a single shift without meperidine can feel impossible.

Remembering childbirth relief
Pethidine is still used for labour pain in the UK, though not as much as in previous years. Because you associate it with such a major life event, meperidine can seem safe and comforting. You may then use it later for other pain or stress, which is a slippery slope to becoming addicted.
Chronic pain with no alternatives
Some people may have received meperidine for long-term pain before doctors stopped prescribing it routinely. When your GP tries to stop it or cut your dose, withdrawal can hit hard and rather than suffer through it, you keep using it. Your original pain may have improved or even gone, but your brain and body still need the drug.
Meperidine and mental health struggles
Depression, trauma, anxiety, and other mental health struggles all make addiction more likely if you are using meperidine to relieve symptoms. Even if it works initially, meperidine addiction almost always makes the underlying issues harder to cope with.

Meperidine side effects and addiction dangers

Meperidine carries all standard opioid dangers plus its unique and potentially deadly risks. These risks are why alternative medications are now usually preferred:

Normeperidine toxicity and seizures
When your body breaks down meperidine, it creates normeperidine, a neurotoxin that builds up the more you take. Normeperidine causes initial tremors, muscle twitching, and myoclonic jerks, then confusion and agitation as levels rise and, eventually, grand mal seizures. These cause a loss of consciousness and violent muscle contractions, which can be medically difficult to control and potentially fatal.
Meperidine overdose
Meperidine also suppresses breathing like all opioids, and high doses can cause respiratory arrest. Symptoms of meperidine overdose include unresponsiveness, blue-tinged skin, and faint breathing. The risk of overdose multiplies with alcohol, benzodiazepines, and other opioids, and you should call 999 immediately if you spot any symptoms.
Serotonin syndrome with antidepressants
Meperidine with drugs like MAO inhibitors, SSRIs or SNRIs can trigger serotonin syndrome. This condition causes agitation, high fever, rapid heart rate, muscle rigidity, confusion, and potentially death.
Cognitive impairment and delirium
Long-term meperidine misuse damages memory, attention, and reasoning, and can also create severe confusion, hallucinations, agitation, and reality disconnection. Some people develop lasting cognitive issues, particularly after seizures or prolonged high-dose meperidine misuse.
Healthcare professional consequences
For medical professionals, meperidine misuse and addiction can mean career-ending consequences. Drug diversion (taking medication that wasn’t prescribed for you) is criminal, and you could face licence suspension or loss, criminal prosecution, imprisonment, and professional ruin.

What does meperidine addiction recovery involve?

Specialised medical care is always essential for meperidine addiction because of normeperidine accumulation, rapid withdrawal, and potential complications. Treatment progresses through three phases:

1. Prescription drug detox

A medically planned and administered drug detox manages both meperidine withdrawal and normeperidine toxicity. For safety reasons, it will usually include:

  • Medications and a gradual transition to longer-acting opioids to help soften withdrawal
  • Neurological monitoring for seizures, tremors, and cognitive complications

2. Opioid rehab

Inpatient treatment is usually advised for meperidine rehab because it is such a dangerous and unpredictable drug. There are countless rehab programmes across Britain, but the best include:

  • Intensive therapy exploring why meperidine addiction developed
  • A combination of evidence-based and holistic approaches
  • Relapse prevention strategy planning for post-rehab risks
  • Both group and one-to-one counselling sessions

3. Post-rehab treatment and support

Top drug rehab programmes provide aftercare, alumni services and possibly sober living services. On top of these, you should also consider:

  • Continued opioid medication-assisted treatment if needed
  • Regular counselling and therapy
  • NA meetings or other local support groups
  • Treatment for co-occurring mental health conditions

For anyone struggling with meperidine addiction, we can help. Contact us today for confidential guidance, advice on the best treatment programmes, or help with staging an intervention for a loved one.

Frequently Asked Questions

What makes normeperidine so dangerous?
Normeperidine is meperidine’s neurotoxic breakdown product with a 15-30 hour half-life (versus meperidine’s 2-4 hours). It accumulates faster than your body can clear it, causing symptoms that progress from tremors to confusion to life-threatening seizures.
Why is meperidine being phased out if it’s still prescribed?
Meperidine produces normeperidine, a toxic metabolite that causes seizures and neurological damage. It may remain in some hospitals for labour pain, but prescriptions are declining as there are now safer opioids available.
Are healthcare workers more likely to become addicted to meperidine?
Yes, direct access to meperidine without prescriptions, pharmacies, or cost barriers makes diversion easy. However, meperidine addiction develops quickly, and professional and legal consequences can be very severe.

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