What is opioids?

Safe use of opioid pain medicine: Overview

Pain involves unpleasant emotions and feelings. Pain feels different for everybody. Only you can describe your pain.

A doctor can suggest or prescribe many types of medicines for pain. These range from over-the-counter medicines like acetaminophen (Tylenol) to powerful medicines called opioids. Examples of opioids are fentanyl, hydrocodone, and morphine. Heroin is an illegal opioid

Opioids are strong medicines. They can help you manage pain when you use them the right way. They can cause serious harm and even death. For these reasons, doctors are very careful about how they prescribe opioids. If opioids are used, your doctor will give you the lowest dose for the shortest possible time.

If you decide to take opioids, here are some things to remember.

  • Keep your doctor informed. You can develop opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. The risk is higher if you have a history of substance use. Your doctor will monitor you closely for signs of opioid use disorder and to figure out when you no longer need to take opioids.
  • Make a treatment plan. The goal of your plan is to be able to function and do the things you need to do, even if you still have some pain. You might be able to manage your pain with other non-opioid options. These include cognitive behavioral therapy (CBT), physical therapy, relaxation, non-opioid prescription pain medicine, and over-the-counter medicines.
  • Be aware of the side effects. Opioids can cause side effects, such as constipation, sleepiness, and nausea. And over time, you may need a higher dose to get pain relief. This is called tolerance. Your body also gets used to opioids. This is called physical dependence. If you suddenly stop taking them, you may have withdrawal symptoms. Serious risks of using opioids include overdose and death.
  • Know the risk factors for addiction. Your risk for opioid use disorder is higher if you have a history of substance use disorder. Other things that increase the risk include being a teenager, being an older adult, having a history of mental illness, and taking high doses of opioid medicine.

The doctor carefully considered what pain medicine is right for you. You may not have received opioids if your doctor was concerned about drug interactions or your safety, or if your doctor had other concerns.

It is best to have one doctor or clinic treat your pain. This way they can find the treatment that will help you the most. And a doctor will be able to watch for any problems that the medicine might cause.

The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away.

Opioid

An opioid is a drug that can suppress the perception of pain and calm a person's emotional response to pain. It does this by reducing the effect of pain signals sent by the nervous system. Opioids produce a feeling of well-being (euphoria). They also cause mood changes, cloudy thinking, and deep sleep. Side effects of opioids may include constipation and nausea. Opioids are also called opiates or narcotics.

Examples of prescription opioids include fentanyl, hydrocodone, and morphine. Heroin is an example of an illegal opioid.

Frequent use of opioids may make a person physically dependent on them. Stopping use or using less may lead to withdrawal. Withdrawal symptoms can include nausea, sweating, chills, diarrhea, stomach cramps, and muscle aches.

Some people who use opioids may develop opioid use disorder. They keep using opioids even though it causes harm to them or others. This can lead to an accidental overdose and death. Moderate to severe opioid use disorder is sometimes called addiction.

What are some examples of opioids?

Here are some examples of opioids and other medicines that have opioids in them. For each item in the list, the generic name is first, followed by any brand names.

  • codeine (Tylenol 3)
  • hydrocodone (Norco)
  • oxycodone (OxyContin, Percocet)

This is not a complete list of opioids.

How can you care for yourself when you use opioid pain medicine?

If you need to take opioids to manage your pain, remember these safety tips.

  • Follow directions carefully. It's easy to misuse opioids if you take a dose other than what's prescribed by your doctor. This can lead to accidental overdose and even death. Even sharing them with someone they weren't meant for is misuse.
  • Be cautious. Opioids may affect your judgment and decision making. Do not drive or operate machinery while you take them. Talk with your doctor about when it is safe to drive.
  • Reduce the risk of drug interactions. Opioids can be dangerous if you take them with alcohol or with certain drugs like sleeping pills and muscle relaxers. The combination can decrease your breathing rate and lead to overdose or death. Make sure your doctor knows about all the other medicines you take, including over-the-counter medicines. Don't start any new medicines before you talk to your doctor or pharmacist.
  • Safely store and dispose of opioids. Store opioids in a safe and secure place. Make sure that pets, children, friends, and family can't get to them. When you're done using opioids, make sure to dispose of them safely and as quickly as possible. The U.S. Food and Drug Administration (FDA) recommends these disposal options.
    • The best option is to take your medicine to a drop-off box or take-back program that is authorized by the U.S. Drug Enforcement Administration (DEA).
    • If these programs aren't available in your area and your medicine doesn't have specific disposal instructions (such as flushing), you can throw them into your household trash if you follow the FDA's instructions. Visit fda.gov and search for "unused medicine disposal."
    • If you have opioid patches (used or unused), your options are to take them to a DEA-authorized site or flush them down the toilet. Do not throw them in the trash.
    • Only flush your medicine down the toilet if you can't get to a DEA-approved site or your medicine instructions state clearly to flush them.
  • Reduce the risk of overdose. Opioids can be very dangerous. Protect yourself by asking your doctor about a naloxone rescue kit. It can help you—and even save your life—if you take too much of an opioid.

Try other ways to reduce pain.

  • Relax, and reduce stress. Relaxation techniques such as deep breathing or meditation can help.
  • Keep moving. Gentle, daily exercise can help reduce pain over the long run. Try low- or no-impact exercises such as walking, swimming, and stationary biking. Do stretches to stay flexible.
  • Help yourself with healthy thinking through cognitive behavioral therapy (CBT). This type of therapy is used to help people think in a healthy way. It focuses on thought (cognitive) and action (behavioral).
  • Try heat, cold packs, and massage.
  • Get enough sleep. Pain can make you tired and drain your energy. Talk with your doctor if you have trouble sleeping because of pain.
  • Think positive. Your thoughts can affect your pain level. Do things that you enjoy to distract yourself when you have pain instead of focusing on the pain. See a movie, read a book, listen to music, or spend time with a friend.

What are long-acting opioids?

Long-acting opioid pain relievers are medicines used to relieve moderate to severe long-term pain. They are also called extended-release opioids. They don't cure a health problem, but they help you manage the pain and function better.

If your short-acting pain medicine is not working, your doctor may give you long-acting opioids. Because of their increased risk of overdose and death, long-acting opioids are usually only given to patients receiving treatment for cancer or end-of-life care.

How can you stay safe when you take long-acting opioids?

Opioids are strong medicines. They can help you manage pain when you use them the right way. But they can cause serious harm and even death.

If you decide to take opioids, here are some things to remember.

Keep your doctor informed.

You can develop opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. The risk is higher if you have a history of substance use. Your doctor will monitor you closely for signs of opioid use disorder and to figure out when you no longer need to take opioids.

Make a treatment plan.

The goal of your plan is to be able to function and do the things you need to do, even if you still have some pain. You might be able to manage your pain with other non-opioid options. These include cognitive behavioral therapy (CBT), physical therapy, relaxation, non-opioid prescription pain medicine, and over-the-counter pain medicines.

Be aware of the side effects.

Opioids can cause side effects, such as constipation, sleepiness, and nausea. And over time, you may need a higher dose to get pain relief. This is called tolerance. Your body also gets used to opioids. This is called physical dependence. If you suddenly stop taking them, you may have withdrawal symptoms. Serious risks of using opioids include overdose and death.

Safety tips when using long-acting opioids

If you need to take opioids to manage your pain, remember these safety tips.

Follow directions carefully.

It's easy to misuse opioids if you take a dose other than what's prescribed by your doctor. This can lead to accidental overdose and even death. Even sharing them with someone they weren't meant for is misuse.

Be cautious.

Opioids may affect your judgment and decision making. Do not drive or operate machinery while you take them. Talk with your doctor about when it is safe to drive.

Reduce the risk of drug interactions.

Opioids can be dangerous if you take them with alcohol or with certain drugs like sleeping pills and muscle relaxers. The combination can decrease your breathing rate and lead to overdose or death. Make sure your doctor knows about all the other medicines you take, including over-the-counter medicines. Don't start any new medicines before you talk to your doctor or pharmacist.

Safely store and dispose of opioids.

Store opioids in a safe and secure place. Make sure that pets, children, friends, and family can't get to them. When you're done using opioids, make sure to dispose of them safely and as quickly as possible. The U.S. Food and Drug Administration (FDA) recommends these disposal options.

  • The best option is to take your medicine to a drop-off box or take-back program that is authorized by the U.S. Drug Enforcement Administration (DEA).
  • If these programs aren't available in your area and your medicine doesn't have specific disposal instructions (such as flushing), you can throw them into your household trash if you follow the FDA's instructions. Visit fda.gov and search for "unused medicine disposal."
  • If you have opioid patches (used or unused), your options are to take them to a DEA-authorized site or flush them down the toilet. Do not throw them in the trash.
  • Only flush your medicine down the toilet if you can't get to a DEA-approved site or your medicine instructions state clearly to flush them.
Reduce the risk of overdose.

Opioids can be very dangerous. Protect yourself by asking your doctor about a naloxone rescue kit. It can help you—and even save your life—if you take too much of an opioid.

What are some cautions about opioids?

Cautions for opioids include the following:

  • Some opioids have acetaminophen (Tylenol) in them, and taking too much acetaminophen can be harmful. So check the labels on all the other medicines you take, because many other medicines also contain acetaminophen. This includes over-the-counter medicines. Do not take other medicines with acetaminophen in them unless your doctor has told you to. Talk to your doctor or pharmacist if you have questions about this.
  • Do not drive or operate machinery until you can think clearly. Opioids may affect your judgment and decision making. Talk with your doctor about when it is safe to drive.
  • Opioids are strong medicines. There is a risk for developing opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. This means a person keeps using opioids even though it causes problems. The risk is greater for those who have a history of substance use. If you are worried about developing opioid use disorder, talk with your doctor.
  • Taking opioids if you have certain health conditions, such as sleep apnea, can slow your breathing rate and lead to serious harm. Opioids can also be dangerous if you take them with alcohol or other drugs like sleeping pills and muscle relaxers. This can lead to an accidental overdose and death.
  • Your body gets used to opioids if you take them for a long time. This is called physical dependence. You could have withdrawal symptoms when you stop taking them. Symptoms include nausea, sweating, chills, diarrhea, and shaking. But you can avoid these symptoms if you slowly stop taking the medicine as your doctor tells you to.

What are alternatives to opioids for pain management?

Your doctor can tell you about many other ways to manage pain.

One option is non-opioid medicines, such as:

  • Acetaminophen.
  • NSAIDs.
  • Certain antidepressants.
  • Certain anti-seizure medicines.

Pain treatment may include other things besides medicine. You may find relief from treatments such as ice or heat, meditation, cognitive behavioral therapy (CBT), and making sure you get enough sleep.

Work with your doctor to explore different options for pain relief.

It's also possible that you could take an opioid for pain for a short time. In that case, it will be very important to work closely with your doctor.

Why are opioids used?

Opioids are used to relieve moderate to severe pain. They may be used for a short time, such as after surgery, or for long-term pain when safer options don't help.

Opioids don't cure a health problem. But they may help you manage the pain and help you function better.

Taking opioids safely: When to call

Call your doctor now or seek immediate medical care if:

  • You have a new kind of pain.
  • You have new symptoms, such as a fever or rash, along with the pain.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You think you might be using too much pain medicine, and you need help to use less or stop.
  • Your pain gets worse.
  • You would like a referral to a doctor or clinic that specializes in pain management.

What are some side effects of opioids?

Some people feel sleepy, feel dizzy or lightheaded, have nausea or vomiting, or become constipated while using an opioid.

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