What is 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.

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.

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.

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.

Regular follow-up visits to your doctor will help you and your doctor make sure that the medicine is the right treatment for your pain. At every visit, your doctor will check these things:

• Is your pain being controlled?
• Are you better able to function and be active?
• Are you having any side effects, like constipation, nausea, or being too sleepy?
• Are the non-opioid pain control measures working? Are there other things you can try?
• Are there any signs that you are misusing your medicine?

While you are taking an opioid, you may have drug tests and prescription history checks from time to time.

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. You may:

• Be constipated.
• Feel sick to your stomach or vomit.
• Feel sleepy.
• Have trouble urinating.
• Have a low sex drive.
• Need larger doses over time.

The risk of overdose and misuse is higher with 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.

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.