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Pain Management Beyond Opioids
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Episode number: 
1504

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Opioid overdose caused more than 42,000 deaths in the U.S. in 2016, and the crisis continues. Every day, more than 115 people in the United States die after overdosing on opioids. Two million Americans are dependent on pain pills and street drugs to deal with their pain. 

Source:  U.S. National Library of Medicine

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some health care providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your health care provider. However, people who take opioids are at risk for opioid dependence, addiction, and overdose. These risks increase when opioids are misused. Misuse means you are not taking the medicines according to your provider's instructions, you are using them to get high, or you are taking someone else's opioids.

How do I know if I need to take opioid medicines?

First, you need to talk with your health care provider about whether you need to take opioids. You should discuss

  • Whether there are other medicines or therapies that might treat your pain
  • The risks and benefits of taking opioids
  • Your medical history and if you or anyone in your family has a history of substance misuse or addiction to drugs or alcohol
  • Any other medicines and supplements you are taking
  • How much alcohol you drink
  • For women - If you are pregnant or planning to become pregnant

What do I need to know if I am going to take opioid medicines?

If you and your provider decide that you need to take opioids, make sure that you understand

  • How to take the medicine - how much and how often
  • How long you will need to take the medicine
  • What the possible side effects are
  • How you should stop the medicines when you no longer need them. If you have been taking opioids for a while, it can be dangerous to just stop suddenly. You may need to get off the medicines slowly.
  • What the warning signs of addiction are, so you can watch for them. They include
    • Regularly taking more medicine than you are supposed to
    • Taking someone else's opioids
    • Taking the medicine to get high
    • Mood swings, depression, and/or anxiety
    • Needing too much or too little sleep
    • Trouble making decisions
    • Feeling high or sedated

If you have a high risk for an overdose, you may also want to get a prescription for naloxone. Naloxone is a drug that can reverse the effects of an opioid overdose.

How can I take my opioid medicine safely?

You should always be careful when taking any medicine, but you need to take extra care when taking opioids:

  • Take your medicine exactly as prescribed - do not take extra doses
  • Check the instructions every time you take a dose
  • Do not break, chew, crush, or dissolve opioid pills
  • Opioids can cause drowsiness. Do not drive or use any machinery that may injure you, especially when you first start the medicine.
  • Contact your provider if you have side effects
  • If you can, use the same pharmacy for all your medicines. The pharmacy's computer system will alert the pharmacist if you are taking two or more medicines that could cause a dangerous interaction.

How can I safely store and dispose opioid medicines?

It is important to store and dispose of opioid medicines properly:

  • Store your opioids and other medicines in a safe place. If you have children at home, it's a good idea to store your medicines in a lockbox. Even one accidental dose of an opioid pain medicine meant for an adult can cause a fatal overdose in a child. Also, someone who lives with you or visits your house may look for and steal your opioid medicines to take or sell them.
  • If you travel, carry the current bottle of opioids with you for safety. This will help you answer any questions about your medicine.
  • Dispose of your unused medicine properly. If you have unused opioid medicines at the end of your treatment, you can get rid of them by
    • Finding a local drug take-back program
    • Finding a pharmacy mail-back program
    • In some cases, flushing them down the toilet - check the Food and Drug Administration (FDA) web site to find out which ones you can flush away
  • Never sell or share your medicines. Your prescription is for you. Your health care provider considers many factors when prescribing opioids. What's safe for you might lead to an overdose for someone else.
  • If someone steals your opioid medicines or prescription, report the theft to the police.

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