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Meperidine Addiction | Side Effects, Withdrawal & Treatment

Published on March 18, 2021
Meperidine Hydrochloride (Demerol) Addiction

Meperidine is an opioid prescription drug often used to help people with acute and chronic pain. It may not be as potent as other opioid painkillers like fentanyl but it still has a high rate of abuse. 

On top of that, the withdrawal symptoms can be as difficult as the side effects of abuse which makes finding the right treatment so important.

What Is Meperidine Used For?

Meperidine, commonly known as Demerol or pethidine, is an opioid analgesic painkiller that works on the central nervous system (CNS) to relieve severe pain. 

It’s often administered as meperidine hydrochloride for intravenous use/intramuscular injection. It’s also available as a tablet.   

Because of its addictive qualities, meperidine isn’t prescribed much outside of a hospital setting and usually only as an anesthetic or a pain reliever for illnesses like pancreatitis. 

How Meperidine Works

Meperidine is an agonist. This means it fills the pain receptors in the brain and body and creates a feeling of euphoria and analgesia similar to morphine. This is why it can be so addictive and why the FDA considers it a Schedule II Controlled Substance

Once in the body, meperidine is metabolized into its metabolite, normeperidine (also known as norpethidine).  Normeperidine has a longer half-life (15-20 hours) than meperidine, so it stays in the body longer and can lead to serious issues.  

Because of the longer half-life, meperidine isn’t recommended for those suffering from chronic cancer pain or renal/hepatic disease.

Signs Of Meperidine Addiction

There are lots of different signs that someone is addicted to meperidine, but a few of the most common include:

  • isolation
  • inability to stop taking meperidine 
  • continue using despite problems with health/relationships
  • improper dosing 
  • lack of interest in things not including meperidine
  • visits to multiple doctors for a meperidine prescription
  • absent at school/work
  • sleeping at odd times
  • changes in appetite
  • mood swings

Meperidine tablets are intended for oral use but people who abuse the drug may:

  • chew tablets
  • crush tablets and snort the powder
  • crush tablets into powder, dissolve the powder into water, and inject it

Side Effects Of Meperidine Abuse

When someone abuses meperidine, many adverse effects may occur. They may differ from person to person, but some of the more common side effects include:

  • nausea
  • vomiting
  • constipation
  • sweating
  • changes in vision
  • respiratory depression
  • serotonin toxicity/serotonin syndrome

Meperidine Overdose Signs

Meperidine abuse can lead to a higher risk of an overdose which can ultimately be fatal. 

Whether you’re addicted to meperidine or not, if you’re taking it, you should talk to your doctor about having naloxone on hand as it can reverse the effects of an overdose by blocking the opiates in the drug. 

When looking for symptoms of meperidine overdose in yourself or a loved one, look out for:

  • extreme drowsiness
  • weak or limp muscles
  • hypotension
  • cold, clammy skin
  • coma or sedation
  • respiratory depression
  • irritability
  • impulsiveness
  • mood swings
  • depression
  • hallucinations

There are also medications that should not be taken with meperidine. Some drug interactions can be life-threatening and increase risk of overdose, including:

  • monoamine oxidase inhibitors (MAOIs)
  • benzodiazepines like diazepam
  • linezolid
  • phenytoin
  • carbamazepine
  • phenelzine
  • pentazocine
  • methylene blue
  • some selective serotonin reuptake inhibitors (SSRIs)
  • other opioid analgesics like butorphanol 

Meperidine Withdrawal Symptoms

While quitting meperidine is the best option when someone abuses it, the symptoms of withdrawal can be just as bad as the side effects of abuse. 

Meperidine withdrawal symptoms may include:

  • restlessness
  • nausea
  • sweating
  • pupil dilation
  • abdominal cramps
  • vomiting
  • diarrhea
  • loss of appetite
  • irritability
  • anxiety
  • insomnia
  • high blood pressure

Meperidine Addiction Treatment

Fortunately, there are lots of treatment options for meperidine addiction. They range from medical detox to evidence-based therapies.

Medical Detox

The most important action someone addicted to meperidine can take is to seek help from a healthcare provider or treatment facility. Professional staff can help keep withdrawal symptoms to a minimum when the effects of the drug wear off.

Some medications, like antidepressants and sleep aids, may be administered to help with specific withdrawal symptoms. 


Counseling and therapy are also important aspects of treatment for meperidine addiction. Therapy helps people learn healthy ways to deal with stress, control cravings, and manage overall mental health.

Cognitive behavioral therapy (CBT) is the most common type of therapy used for people with drug addiction. CBT helps change behaviors by challenging unhelpful thoughts and attitudes towards substance use.

Please call our helpline today to learn more about our addiction treatment programs.

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

American Journal of Therapeutics - Meperidine and normeperidine toxicity
FDA - Demerol
National Library of Medicine: MedlinePlus - Meperidine
National Library of Medicine: MedlinePlus - Meperidine Injection

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