Opioids are drugs that work by reducing the intensity of pain signals that reach your brain. These drugs can be helpful for a short time but they have serious risks.
Commonly prescribed opioids include hydrocodone, oxycodone, codeine, morphine, and fentanyl. Heroin is an opioid.
When considering taking opioids, weigh the risks of addiction and overdose against the expected benefits. Non-opioid medications or pain treatment options that do not involve prescription drugs can be effective with less risk. Non-steroidal anti-inflammatory medications (such as ibuprofen and others) may be as effective as or better than opioid medications for some types of pain. Also, research shows that physical therapy can help manage pain and improve your body’s function with less risk than prescription opioids.
Prescription opioids can be an important part of treatment in some circumstances (like an acute injury or surgery) and can effectively relieve suffering for patients with active cancer or others in hospice or palliative care. Opioids can provide short-term benefits for moderate to severe pain. But scientific evidence is lacking for the benefits of opioids to treat chronic pain (more than 3 months).
Manage Your Pain
For pain, you should receive treatment that is tailored to the type of pain you’re experiencing and supported by available scientific evidence. There are other types of treatment for chronic pain to consider as first-line treatment before opioids. Whatever the choice, the risk shouldn’t outweigh the benefits. Here are some recommended treatments for low back pain, fibromyalgia, and osteoarthritis.
Fact Sheet :
Overdosing on Opioids Can Happen by Accident
Due to their effect on the part of the brain which regulates breathing, opioids in high doses can cause slow breathing (respiratory depression) and death. It is especially dangerous to combine opioids with alcohol or sedatives, like benzodiazepines (e.g., lorazepam/ativan, alprazolam/xanax, diazepam/valium). Combining opioids with alcohol and sedative medications increases the risk of respiratory depression and death, and combinations of opioids, alcohol and sedatives are often present in fatal drug overdoses.
Opioid Drugs Are Addictive
Up to 1 out of 4 people receiving long-term opioid therapy in a primary care setting struggles with addiction. Addiction is a chronic illness with symptoms of uncontrollable cravings, inability to control drug use, compulsive drug use, inability to meet work, social, or family obligations, and use despite doing harm to oneself or others. The cravings in addiction are rooted in changes to the brain. One aspect of recovery is the process of reversing, to the extent possible, these brain changes.
In addition to the serious risks of overdose and addiction, the use of prescription opioids can have a number of side effects, even when taken as directed. You can develop tolerance to opioids, which means you might need more of the medication for the same pain relief. You can develop physical dependence on opioids, which means that you have symptoms of withdrawal, like drug craving, anxiety, insomnia, abdominal pain, vomiting, diarrhea, and tremors, if you suddenly stop taking the medication.
Other side effects include constipation, nausea, vomiting, dry mouth, sleepiness, dizziness, confusion, and increased sensitivity to pain.
If you and your prescriber choose opioids to manage your pain, follow these steps to avoid risk of addiction or overdose:
Start low and go slow – your prescriber should give you the lowest dose for the shortest amount of time possible.
Never take opioids in greater amounts or more often than prescribed – otherwise addiction or overdose become more likely.
Avoid taking opioids with alcohol. Mixing can increase your risk of overdose.
Avoid mixing opioids with the following medications when possible (unless otherwise advised by your prescriber):
- Sedatives or tranquilizers, including benzodiazepines (such as Xanax and Valium)
- Muscle relaxants (such as Soma or Flexeril)
- Sleeping pills or hypnotics (such as Ambien or Lunesta)
- Other prescription opioid pain relievers
However, there may be circumstances where prescribing opioids with these medication is necessary and acceptable. Also, your prescriber may use urine drug tests and check your prescription history to help make prescribing decisions that ensure your safety.
Follow up regularly with your healthcare professional to monitor how the medication is working, side effects, or signs of opioid use disorder (like addiction).
If you’re taking opioids for an extended period of time, you should taper – with the guidance of your health care professional – as your pain subsides until you’re off opioids completely. If you’re taking high doses or long-term opioids, consider having naloxone on hand. Opioids aren’t made for long-term use; the more you use them, the more your body builds a tolerance. You’ll have the same level of pain, but need more opioids – increasing your chances of overdose or addiction. Long-term use of opioids can be appropriate for some patients receiving active cancer treatment, palliative care, and/or end-of-life care.
Using another person’s opioid medications is a major way that people have become addicted or overdosed
Safe Storage & Disposal
You’ll need to store opioid painkillers in a safe place and out of reach of others. Make sure to responsibly dispose of any unused opioids. Check for your community drug take-back program or your pharmacy mail-back / return program to safely dispose of unused opioids. For more information, see the Food and Drug Administration opioid disposal site and the DEA’s disposal location tool.
Taking opioids responsibly means also preventing misuse and abuse by not selling or sharing prescription opioid painkillers. This is a major issue: over 65% of people misusing painkillers are getting them from family and friends. Sharing medications can be dangerous and contribute to overdose and addiction.
Help is a Call Away
Opioid use disorder can occur when a patient has a hard time controlling his or her opioid use, which results in significant health or social problems. There are effective treatments for opioid use disorder. If you or someone close to you has an addiction to pain medication, talk to your health care professional or contact the Substance Abuse and Mental Health Services Administration’s treatment help line at (800) 662-HELP.
Association of State & Territorial Health Officials
Federation of State Medical Boards
National Safety Council