What are opioids?
Opioids are natural and synthetic forms of opium including the illegal drug heroin and prescription pain relievers (some examples: codeine, morphine, oxycodone, hydrocodone, hydromorphone, fentanyl, tramadol, oxymorphone). Methadone is another opioid used to treat pain and people recovering from opioid addiction.
Will opioids help my pain?
Prescription opioid medications are usually given as pain relievers after surgery, dental procedures, major injury, as an effective pain relief for patients with active cancer, and others in hospice/end-of-life care.
They can provide short-term relief for moderate to severe pain. They may not take the pain away completely but help keep it under control.
Generally, they are not the most effective treatment for chronic, long-term pain. Over time, they can make the pain worse.
What are the side-effects of opioid use?
Side-effects include mind and mood changes, sleep disorders, drowsiness, dry mouth, and tooth decay, breathing and heart problems, low sex hormones, opioid-induced hyperalgesia (increased sensitivity to pain), constipation, and bowel dysfunction, physical dependence and tolerance, and accidental overdose or death.
What are the risks of opioid use?
Many people have used opioid medications without problems. However, these medications have several risks and side effects, even when taken as directed.
Use of opioid medications puts patients at risk for:
- Tolerance – needing more medication to achieve the same effects
- Hyperalgesia – Increased sensitivity to pain
- Physical dependence – Having physical withdrawal symptoms when a medication is stopped
- Addiction – A chronic disease where a person cannot control use despite the harm caused
- Unintentional overdose, or death
Risk of opioid overdose increases with:
- Living Alone
- Taking additional medications
- Higher doses of opioids
- Having multiple chronic diseases
- Getting a lung infection
- Having sleep apnea
The ability to drive or operate machinery may be impaired.
Pregnant women who are using opioids may put their children at risk.
Guidelines for opioid use:
Avoid the following while using opioids: (Unless advised by your health care provider)
Alcohol, Hypnotics (Ambien, Lunesta), Muscle relaxants (Flexeril, Soma), Sedatives/Anti-Anxiety (Valium, Xanax), Other opioid pain relievers.
- Do not take your medications in larger amounts or more often than prescribed.
- If you would like to stop your medication, talk to your doctor to get a proper tapering schedule. Stopping the medicine at once can make you feel sick.
- Many opioid medications and over-the-counter products also contain acetaminophen. Do not exceed a total of 3 gm acetaminophen daily.
- Never share or sell your medications or use someone else’s.
- Ask about Naloxone or Narcan, a medication to reverse the opioid-related overdose.
- Discuss with your health care provider:
- Your full medical and substance use history
- The medicines you are taking (prescribed, over-the-counter, herbal and alternative).
- Concerns, and medication side effects
- If you still need the medication or can take a lower dose.
- A plan for pain control, especially if you need opioids for more than 1-2 weeks.
- Non-opioid options. Some may work better and have fewer side effects.
Studies have shown that when patients decrease the dose of opioid medications, the risks and side effects of use decrease, and pain does not get worse.
Safe Storage and Disposal of Medications
To help prevent accidental ingestion, misuse, or overdose by others, especially children:
- Store your medications in a locked box or cabinet.
- Dispose of all your unused, expired, or unwanted medications properly. Do not flush them down the toilet.