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24 hours rehab
Immediate Access for help and advice

What Is Demerol?

Meperidine or Pethidine, sold under the brand name Demerol, is an artificial piperidine ester that exhibits opioid analgesic activities. When taken, meperidine acts on the opioid receptors by imitating the activities of endogenous neuropeptides. This leads to the production of morphine-like effects such as respiratory depression, sedation, analgesia, euphoria, bradycardia and physical dependence on the mu-opioid receptor.

Meperidine has been nicknamed ‘the doctors’ and nurses’ addiction’ because a study conducted in the US found that out of the 280 Pethidine addicts admitted to a US psychiatric hospital, 186 were healthcare workers. In Canada, a study found that 56% of Quebec physicians preferred meperidine compared to 38% who preferred morphine. (1)

Meperidine is used to relieve pain in patients suffering from moderate to severe pain. It is classified under opioid (narcotic) analgesics and possesses similar characteristics to morphine. The drug affects the brain and changes how a person’s body feels and responds to pain. There is no evidence of a connection between meperidine and serum enzyme elevations during therapy.The drug is not recommended for long-term treatment of ongoing pain. It is mostly used for the treatment of sudden episodes of average to acute pain.

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Demerol brand and street names

Some of the brand names for meperidine hydrochloride besides Demerol include Pethidine, Meperidol and Dolantin.

Demerol has other names that individuals use to refer to it on the streets. Some of these include dust, dillies, smack and demmies, among others.

Legal Status (UK)

The Misuse of Drugs Act 1971 lists drugs that are controlled by the United Kingdom. Possession of the drugs listed in the act results in lenient punishment compared to supplying or possessing the drugs with the intention of supplying, which is dealt with seriously and may even lead to life imprisonment.

Drugs are listed in three categories: Class A, B and C, with Class A drugs carrying harsh punishments because they are considered extremely dangerous

Demerol is listed under Class A, meaning that it is highly controlled with a strong potential for abuse. It cannot be legally obtained without a prescription. The psychoactive drug is to be used for legitimate medicinal purposes only. However, chances of the drug being illegally possessed by individuals are high, and this poses a great danger to the user and those around them.

Routes of Administration

Meperidine may be administered to a user either orally, via intravenous therapy or by intramuscular administration.

When the solution is administered orally, a physician should prescribe an accurate amount of the oral solution to prevent dosing mistakes that may result in an accidental overdose that may be fatal to a patient.

When administered via intramuscular administration, the drug is injected into a large muscle mass for faster absorption because such muscle tissue has a greater blood supply than the tissue just under the skin. When a patient is given repeated injections, intramuscular injection is preferred to subcutaneous injection.

For intravenous therapy, the patient will be injected with 10 milligrams per millilitre slowly. It should, however, be administered by a medical professional due to the sensitivity of the injection.

Routes of Administration

Meperidine may be administered to a user either orally, via intravenous therapy or by intramuscular administration.

When the solution is administered orally, a physician should prescribe an accurate amount of the oral solution to prevent dosing mistakes that may result in an accidental overdose that may be fatal to a patient.

When administered via intramuscular administration, the drug is injected into a large muscle mass for faster absorption because such muscle tissue has a greater blood supply than the tissue just under the skin. When a patient is given repeated injections, intramuscular injection is preferred to subcutaneous injection.For intravenous therapy, the patient will be injected with 10 milligrams per millilitre slowly. It should, however, be administered by a medical professional due to the sensitivity of the injection.


Meperidine is found in the phenylpiperidine class. Its chemical structure resembles local anaesthetics, and the drug is prescribed to alleviate mild to severe pain. Meperidine is also used for peripheral nerve blocks and intravenous regional anaesthesia and as an intraarticular, spinal and extradural pain reliever. The drug has a potential of blocking and terminating biopsy chills caused by amphotericin B.

Mechanism of action

The drug is a kappa-opiate receptor agonist and produces local anaesthetic effects. Meperidine has a higher bonding ability with the kappa-receptor compared to morphine. As regulators of synaptic transmission through the G-proteins, opiate receptors have both productive and obstructive functions. Opioids also cause reduced neuronal excitability and hyperpolarization because they hinder vasopressin release, insulin, somatostatin and glucagon production.

Chemical formula – C15H21NO2

The molecular formula C15H21NO2 refers to Demerol, which has an average mass of 247.333 Da and a monoisotopic mass of 247.157227 Da. Demerol is the archetype of a large family of painkillers like bemidones (ketobemidone), pethidine 4-phenylpiperidines, prodines (alphaprodine, MPPP, etc.), piminodine, anileridine and remote ones like the diphenoxylate and analogs. This chemical formula explains why it can be stable at room temperature.

Demerol Addiction and How It Develops

A person becomes addicted to Demerol when they start abusing the drug on a frequent basis and become physically and psychologically dependent on the drug. When they reach this stage, most users cannot carry out their daily activities without taking Demerol.

Patients may not even realize they are abusing the substance. They begin consuming the drug as prescribed by the doctor and this leads to tolerance, especially if it’s prescribed for long. Users end up raising the dose to feel more relief, and this is what causes physical dependence on the drug, followed by a psychological dependence in some cases.

Physical dependence is manifested when the user starts experiencing irritating drug withdrawal symptoms once they stop taking Demerol. Addiction to Demerol can be ascertained when the drug user acts in ways that are detrimental to themselves and families in order to continue abusing the drug. (5)

Several addicts use Demerol in large doses, regularly and for a prolonged period. They tend to consume the drug by chewing, crushing the tablets or snorting the powder. Some crush and mix the powder to inject it instead of consuming it orally as prescribed by doctors.

Why is Demerol addictive?

Demerol is addictive because it reacts very swiftly and its effects are similar to those produced by morphine. Its short-acting effects make it best in relieving moderate to severe pain. However, this is what increases the potential for abuse. (5)

Demerol is abused for its euphoric effects, which gives the user serenity and light-headedness. This causes an individual to start abusing the psychoactive drug in methods that will escalate the drug analgesic properties. A euphoric, powerful rush produced by the drug is what makes the drug highly addictive. This is usually accompanied by prolonged sedation.

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Causes & Risk Factors in Demerol Addiction

Several factors may contribute to a person abusing and becoming addicted to Demerol. Researchers agree that a person’s genetics is one of the major causes and risk factors that make a person vulnerable to Demerol abuse and addiction.

There is abundant evidence that genetic features like novelty seeking and impulsivity raise an individual’s likelihood of developing Demerol addiction. Furthermore, scientists have noted that a large number of people addicted to Demerol come from a family that has a history of substance use disorders.

The topic of substance addiction and abuse is complex, but it is evident that there are a number of causes and risk factors that play a role in influencing the chances a person has in becoming addicted to Demerol. Researchers have pinpointed several factors that may contribute to an individual’s addiction to Demerol, including:

  • Impulsivity
  • Early exposure to substance abuse
  • Family history of substance use disorders
  • Family history of mental illness
  • Illness or injury that is treated with Demerol
  • Poor stress-management capabilities
  • Conduct disorder during childhood
  • Trauma
  • Poverty


Research from animal models indicates that environmental and social stresses are significant predictors of mental disorders and proves that such stresses and pressure raise the likelihood for substance abuse and makes a user vulnerable to addiction.

Normally, the brain adjusts and reacts to the surroundings and conditions of where a person stays. Addiction is a chronic disorder of the brain. Some persons are more vulnerable to substance use and addiction compared to others because of the social and environmental factors they interact with.

People who cannot cope with high levels of stress are more vulnerable to opioid use, which includes abusing Demerol. Associating with relatives or family members addicted to Demerol and having access to Demerol are also some of the environmental factors that contribute to addiction.

Biological and sensitivity

Classical genetic studies of opioids show remarkable inborn drug use behaviour. To understand how biological and sensitivity factors predisposes people to drug addiction, certain genetic variants have been researched and found responsible for the addictive behaviour. (7)

Personality features like novelty and impulsivity have been found to increase the chances of an individual developing opioid use disorder and ending up abusing substances like Demerol and similar opioid substances.

According to genetic research, individuals coming from a lineage of substance users are at high risk of developing a similar addiction.

Personality and psychological

Opioid dependence, especially Demerol addiction, is a serious condition related to considerable social, psychological and medical impairment. Poor treatment outcomes may also contribute to dependence. A number of psychological, biological and socioeconomic factors are also believed to be involved. (8)

Personality traits at some part may contribute to Demerol addiction. A good example is seen in situations where Demerol addiction arises as a result of self-medication in emotionally unstable persons or from seeking thrills with psychoactive drugs by adrenaline junkies.

A certain study proposes a five-factor model to explain the personality trait theory with opioid dependence. The five factors in the study were extraversion, agreeableness and conscientiousness, openness to experience and neuroticism. The study suggests that individuals with serious substance use disorders have a similar personality profile of low conscientiousness, low agreeableness and high neuroticism.

Signs and Symptoms of Demerol Addiction

The number of people abusing prescription opioids such as Demerol has skyrocketed over the years. This is due to the fact that many people feel that the psychoactive drug is not hazardous because it is not considered as a street drug. However, the fact is that prescription drugs are even more dangerous than some illicit drugs and have ended up causing a number of deaths.

Abuse and addiction are likely to lead a number of symptoms to the user. The first major symptom that indicates that a person is addicted to Demerol is tolerance to the drug, where they start taking more doses of the substance than required to feel the same euphoric effect.

The increase in the number of Demerol doses is what makes the user vulnerable to serious health conditions as the drug starts affecting the user’s internal organs.

An individual addicted to Demerol will start exhibiting various physical, behavioural and psychological symptoms. In most cases, the signs and symptoms indicate that someone is using Demerol inappropriately. The following are some symptoms that most people addicted to Demerol will manifest.

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Emotional/mental state

Demerol addiction affects the brain receptors responsible for emotional state. When a person takes this psychoactive drug, it affects their moods by raising some emotions and lessening others.

Since Demerol is an opioid, it functions by altering the reward and pleasure part of the brain as well as hormonal levels. For a person with depression, the opioid will be less effective, and they may end up taking large doses to get the desired effect. That is why a thorough screening is required before a user is put on Demerol or any painkillers. Some emotional symptoms include:

  • Depression
  • Intense mood swings
  • Unremitting anxiety
  • Impulsiveness
  • Agitation
  • Irritability


From a clinical standpoint, Demerol addiction and dependence are as a result of the user avoiding the painful withdrawal factors, and this is what pushes him or her to continue using the psychoactive drug.

Demerol addiction causes changes in the user’s behaviour. In many cases, this results in a change in lifestyle because they start doing things they never used to do.

The adjustment in behaviour of the user is to enable them to access the drug. The following are some of the behavioural signs that may indicate a person is using Demerol.

  • ‘Drug-seeking’ behaviours
  • ‘Nodding out’ – or appearing in a daze
  • Forging prescriptions for Demerol
  • Craving the drug when it is unavailable
  • Increasing the dose to achieve similar effects
  • Doctor-shopping to obtain more prescriptions for Demerol
  • Lying about the amount consumed
  • Stealing or borrowing money from friends and loved ones
  • Taking other people’s prescriptions
  • Stashing Demerol around places at home, work, or in the car
  • Withdrawing from previously pleasurable activities
  • Neglecting responsibilities at work and at home


Demerol is an opioid that acts on the opioid receptors, leading to brain changes that are manifested physically. Such changes are an indication that a person is abusing Demerol.

The physical changes may be short term or long term. Most of the short-term ones develop to cause adverse health conditions when used for a long period. Since Demerol is a short-acting drug, there will be immediate physical symptoms, such as breathing difficulty that may affect the brain due to a limited oxygen supply. Below are some of the physical symptoms that show a person is using Demerol for non-medical purposes:

  • Difficulty breathing
  • Dry mouth
  • Headache
  • Liver problems
  • Pruritus
  • Nausea and vomiting
  • Hypotension
  • Sedation
  • Constipation
  • Kidney problems
  • Dizziness
  • Disorientation
  • Sweating
  • Seizures
  • Coma
  • Heart attack
  • Stroke
  • Death


A person abusing Demerol is likely to become psychologically dependent on the psychoactive drug. The drug contains addictive chemicals that change the entire brain chemical production, leading to tolerance and forcing the user to take the drug to function normally.

When psychological symptoms emerge, it is an indication that the user has taken the drug for long and it is time for them to seek medical assistance before they develop serious health conditions. Unlike physical symptoms that are easy to see, psychological symptoms take time to be noticed. Below are the common psychological symptoms evident in Demerol users.

  • Exacerbation of symptoms of mental illness
  • Worsening depression
  • Hallucinations
  • Delusions
  • Psychosis

Long-Term Effects of Demerol

Most people abusing Demerol are under the illusion that the drug has no long-term effects since it stays in the user’s system for a short period of time.

However, medical studies have revealed that the drug causes devastating health conditions because it alters the brain receptors. This causes the brain to stop producing its natural chemicals, making a person dependent on the drug. That’s why the drug is prescribed by physicians for short-term usage.

Below are some of the serious long-term effects of the psychoactive drug:

  • Social isolation
  • Worsening physical and emotional well-being
  • Suicidal thoughts
  • Coma
  • Death
  • Depressive disorders
  • Anxiety disorders
  • Schizophrenia
  • Bipolar disorder
  • Post-traumatic stress disorder
  • Other substance addiction
  • Alcoholism

Co-Occurring Disorders with Demerol Addiction

Demerol works by changing the way a person’s brain normally functions. Since the brain is a delicate organ, chances of the user developing mental illnesses are high. This is because the brain responds by adapting to the presence of the psychoactive drug, putting the user at a high risk of developing a substance use disorder. Substance use disorders fall under mental health disorders. (9)

Co-occurring disorders occur when a person is diagnosed with both substance abuse disorder and another mental health disorder. Such mental health disorders increase the likelihood of a person to seeking relief from opioids like Demerol. This increases the chances of a person developing a serious mental condition. (9)

Some users have been found to have more than one mental health disorder. Addiction is associated with some mental illnesses. More than half of Demerol addicts were found to have a mental illness beforehand. However, in some people, the addiction triggered mental illness. Since addiction and mental health issues are closely related to one another, it is advisable that they be treated simultaneously for overall improved health care.The following are the common co-occurring disorders are closely linked with Demerol addiction: other substance use disorders, depressive disorders, anxiety disorders and post-traumatic stress disorder (PTSD).

The Relationship Between Demerol and Other Substances

When combined, CNS depressant drugs and opioid analgesics have been noted to have narrow therapeutic effects in some of the patient populations. It is recommended that the simultaneous use of such products be avoided because of the known risks of altered mental states, respiratory depression and postural hypotension.

Demerol is a powerful painkiller. Patients should be careful not to mix the psychoactive drug with other drugs, especially the central nervous system (CNS) depressants. This is because mixing Demerol with CNS depressants like alcohol and benzodiazepine has been known in many cases to increase the risk of coma, overdose, cardiac arrest, seizure, extreme sedation and respiratory failure and even lead to death.

Other substances that have strictly been prohibited from being mixed with Demerol are stimulants. Stimulants can be potentially harmful when combined because they will end up working against each other. If the stimulant is powerful, it will mask the effects of Demerol, and if it is weak, its effects will be masked by Demerol.

This may lead to an overdose because the user will end up taking more of one drug to dull the effects. Speed balling is the term used to refer to the combination of stimulants and depressants.

Demerol Withdrawal

Long-term abuse of Demerol results in alterations in the user’s brain. These changes are proof that an individual has developed an addiction to Demerol. Withdrawal happens when the addict who was dependent on Demerol reduces the amount they take or stops using the drug. The body responds by attempting to adjust to the lack of Demerol in the body, causing withdrawal symptoms like mood swings and anxiety.Demerol withdrawal symptoms are not deadly like other drugs’ withdrawal. However, symptoms are usually painful, and it is recommended that the rehabilitation process is conducted under strict supervision by a physician.

Users taking the drugs under prescription instructions should not abruptly stop using Demerol without consent from their doctor. They are required to consult on ending the treatment and the available alternatives for coping with the dangerous withdrawal symptoms.Demerol patients are also not allowed to change their dosage levels or treatment timetable without medical approval. In most cases, the doctors steadily lower the user’s Demerol dose so the body has enough time to adjust to less medication.

Symptoms of withdrawal

Users quitting Demerol may experience different symptoms depending on how long they abused the drug, the amount of the drug consumed, whether they combined Demerol with other drugs, frequency of consumption, how they administered the drug and their mental and physical health.

Withdrawal symptoms include hallucinations, nausea, insomnia, running nose and eyes, paranoia, anxiety, agitation, vomiting, restlessness, sweating, dry mouth, high blood pressure, loss of breath and muscle pains.Users may also feel strong cravings after they stop taking the drug, which may cause them to relapse. To prevent a relapse, it is advisable that they seek an inpatient medical detoxification program.

Duration of withdrawal and timeline

The timespan of withdrawing from Demerol varies from person to person, but the majority of users experience withdrawal symptoms in less than 24 hours after the last dose. However, there are those who are hit by the withdrawal three hours after quitting. (2)

The user undergoes two withdrawal phases when detoxing from Demerol: acute withdrawal and post-acute withdrawal symptoms (PAWS).

The acute withdrawal is the first phase and normally lasts from three to 10 days while the PAWS phase last for more than that, in some cases as long as 24 months. The symptoms fade as time passes by.

First 24 hours

This is the first phase and the user experiences unpleasant symptoms three to 24 hours after taking the last dose. The user experiences irritating signs like anxiety, nausea, physical discomfort and irritability. During this phase, urges are very strong and if not closely monitored, a recovering user may relapse.

Day 2–5

At this stage, the withdrawal symptoms worsen and continue increasing over some few days. The user starts feeling uncomfortable, scared or frightened. Physical symptoms start manifesting. Some common physical signs at this stage are nausea, vomiting, nausea, sweating and muscle aches. The user also experiences a strong urge to take Demerol.

Day 6–14

After one or two weeks, the withdrawal symptoms start disappearing. The remaining symptoms are not painful, and the user starts adjusting well to the whole process. This is the stage where the second phase, PAWS, begins.

Day 15 and onwards

This is the last phase of the withdrawal phase, and the user may still feel the urge to take the drug again. Feelings like depression, mood swings, restlessness, inability to feel pleasure, poor concentration, decreased appetite, agitation, anxiety, lack of motivation and insomnia will be fading away.

Demerol Addiction Treatment

Demerol is a powerful, addictive painkiller that results in severe physical withdrawal for patients who quit using the drug after using it for a long time. Quitting the drug abruptly may lead to stomach aches, signs of fever, vomiting, anxiety, nausea, restlessness and muscle aches. These withdrawals are painful but can be properly managed in a medical facility.

This is why patients withdrawing from such drugs are required to seek medical care for supervised detox in case of any complications during the drug withdrawal process.

There are many treatment options available to Demerol users who have developed physical dependence or psychological addiction. The following are some of the treatments available to the patients.

  • Medical detox
  • Tapering
  • Group counselling sessions
  • Therapy sessions
  • Inpatient Rehab
  • Outpatient Rehab

Inpatient and outpatient treatment

Inpatient treatment allows Demerol addicts to receive treatment while staying in the facility 24/7 until the completion of the treatment. This type of program provides clients with around-the-clock surveillance and is helpful to clients who are seriously addicted to the psychoactive drug.

Outpatient treatment is preferred by most clients because they are able to attend sessions while carrying out daily activities. Clients who choose this treatment setting should not be highly dependent on Demerol. Outpatient treatment is also a second phase for clients who were previously admitted to the facility and seek some services such as counselling after recovery.

Medication used during treatment and recovery

During the detox process, the client may experience some painful withdrawal symptoms, and the doctor may have to put them on medication to ease the pain. The most common way is usually by switching Demerol to a similar drug like Suboxone or Subutex.

These medications help relieve irritating opioid withdrawal symptoms. They possess a similar active ingredient called buprenorphine. Suboxone also possesses another powerful component that is an opioid antagonist called Naloxone. Naloxone blocks the euphoric effects of opioids. This reduces the user’s urge to experiencing such effects and prevents a relapse.

Therapy for Demerol Addiction

Cognitive behavioural therapy is currently applied in rehabilitation. CBT teaches those recovering from addiction and mental illness to find connections between their thoughts, feelings and actions. This helps increase awareness of how these things impact recovery.

The therapy works by assisting the addicts to overcome the problematic thoughts and feelings that pushed them toward addiction.

Cognitive behavioural therapy is used in treating various substance use disorders and teaches former addicts how to harmonise their thoughts, feelings and actions in order to control their reactions in tempting environments after they complete the recovery process.

12-step programme

The 12 steps have been acknowledged as the benchmark for recovery from almost any type of substance use disorder. It is among the oldest treatment programs and was developed by alcoholics who wanted to overcome alcohol addiction. Over the years, the 12-step programme has been applied in several substance use disorders and addictions.


Individual therapy involves private sessions between a client and a therapist. The therapist’s aim is to find out what triggers activate the client’s addiction and also help them have a positive mindset that will help them thrive after the treatment. The sessions are tailored to meet the client’s specifications and may be conducted outdoors or in a classroom or office.


Group therapy is encouraged because doctors understand that the journey to recovery is a challenging one. Putting former addicts into groups will teach them new survival techniques, raise their confidence levels and help them form sincere friendships with fellow recovering users. The group is usually led by a qualified mental health professional and they may take place three or more days a week.


Family therapy for substance addiction involves counselling the client’s family members and educating them on how to prevent their loved one from relapsing and how to assist them through the recovery process. The counselling session may involve family members like parents, children and spouses. Therapists help the family improve their relationship by establishing proper communication techniques to help members understand each other.

Demerol detox

This is the first step in the treatment plan of Demerol addiction. Rehabilitation personnel help the client to remove Demerol toxins from his or her body. There is constant monitoring to help the client go through the process quickly and successfully by dealing with any withdrawal signs that may be occur.

Demerol abuse detox

Detoxification can be done at home or in medical facilities. It is, however, advisable for the process to be done in medical facilities under medical supervision. Demerol detoxification is the first stage a patient undergoes when seeking addiction treatment at the rehabilitation centres.

Demerol users should consult a doctor before quitting, and those using the drug without prescriptions should see an addiction professional for an evaluation of whether they can complete the withdrawal process in a medical detox program.

Medical detox for Demerol

During medical detox, physicians may opt to taper off the user’s Demerol dose over a period of months or weeks. However, it is common for the doctors to put the user on another equivalent substance like Suboxone, Subutex or buprenorphine.

All methods help to decrease the harshness of the withdrawal symptoms, and both are pleasant and safer than a home detox or cold turkey. The physician may prescribe medications to ease the withdrawal process.

The Cost of Demerol Abuse to Society

In 2016, a total of 2,383 drug misuse deaths were reported in England, representing an increase of 3.6% from 2015. This was the highest number reported in England. Drug deaths are usually caused by drug abuse, drug poisoning or where any drugs restricted under the Misuse of Drugs Act 1971 are involved. (10)

Deaths involving opioids such as heroin account for a large number of drug poisoning deaths. The number of deaths as a result of opioids has doubled in England since 2012. A rising number of deaths has been observed involving new psychoactive drugs and prescription over-the-counter medicines such as Demerol and tramadol.

In 2016, 80% of drug misuse deaths in the UK were random poisonings. Cases of persons committing suicides by abusing drugs have been steadily increasing since then.

The cost of opioid abuse, including Demerol, has resulted in several harmful effects to users such criminal activity, deteriorated physical and mental health, unemployment, homelessness, family separation and ultimately death.

The accumulated costs to the family, community and individual are devastating and include things like motor vehicle crashes, increased spread of infectious diseases, increased medical expenses, loss of productivity, reduced quality of life and abuse and neglect of children.

Take Control of Your Life — Get Started on the Road to Recovery

When a user is recovering and begins feeling confident again, they are encouraged to take control of their life and decide what they want they want to accomplish in life since they are no longer hindered by drugs or alcohol. The following are ways in which users can take control of their lives.

  • Manage their emotions
  • Prioritize self-care The former user should strive to get enough sleep, see a doctor frequently for check-ups, maintain a healthy weight, undergo recommended mental and physical health screenings and stick to a healthy diet.
  • Accepting the past For the user to move forward, they must acknowledge where they have been and how their past experience has forged their current life.
  • Accept their current situation.Accepting the situation is one of the most important things a person can do. Former users should avoid self-blame, anger, guilt and regret because they are not helpful. Instead, they should focus on the present and change what they don’t like about their situation.
  • Know what their values are The user should choose a direction that allows them to redefine core values that will help them stay sober, motivated and inspired.
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