Risks

Regular use of opioids — even as prescribed by a doctor — can lead to dependence and, when misused, can lead to overdose and death. The first step to taking medication safely is to discuss the risks and benefits with your healthcare provider. Make sure you understand why you are taking a certain medicine and how it affects your body.

If you are prescribed an opioid, ask your dentist, healthcare professional or pharmacist the following questions before filling the prescription:

  1.    What is the goal of this prescription?
  2.    When and how should I take these?
  3.    How long should I take these drugs?
  4.    Are there any risks for me from this medication?
  5.    What do I do with any extra medication?

Know what to expect from your healthcare provider. If your provider is prescribing opioids for acute pain, you can expect him or her to protect your safety in some of the following ways.

Your provider may:

  • Prescribe the lowest effective dose of immediate release opioids
  • Prescribe treatment for 3 days or less, which is usually enough for most acute conditions
  • Ask you to follow up if your pain is not resolving as quickly as expected

It is critical to know exactly how much and how often to take the opioid pain medications you are prescribed, as well as how to safely store and dispose of them.

  • Never take opioids in higher amounts or more often.
  • Store opioids in a secure place and out of reach of others than prescribed (including children, family, pets, friends, and visitors).
  • Do not combine opioids with alcohol or other drugs.
  • If you have unused opioids at the end of your treatment take them to the nearest drop box or obtain a medication disposal bag from your local health department.
  • Never sell or share prescription opioids.

Tips for responsible use:

  • When picking up a prescription from the pharmacy, double check that it’s the medication you were expecting to pick up.
  • Read all warnings and follow dosing instructions precisely.
  • Once you get home, it can be helpful to create a list of each medication that you take along with its strength, dose, and the prescribing doctor.
  • Remember to tell your doctor or pharmacist if you missed a dose, overdosed, or experience any side effects.

Know your risks. It is critical to understand the potential side effects and risks of opioid pain medications.

Even when taken as directed, opioids can have several side effects including:

  • Tolerance, meaning you might need to take more
  • Physical dependence, meaning you have withdrawal when a medication is stopped
  • Constipation, which can develop within a few days
  • Nausea and vomiting
  • Confusion
  • Dry mouth
  • Depression
  • Sleepiness and dizziness
  • Itching

Anyone who takes prescription opioids can become dependent upon them. You may also develop tolerance—meaning that over time you might need higher doses to relieve your pain, putting you at higher risk for a potentially fatal overdose. You can also develop physical dependence—meaning you have withdrawal symptoms when the medication is stopped.

  • Tell your healthcare provider about your medical history and if you or anyone in your family has a history of substance misuse or addiction to drugs or alcohol. Also, never take opioids in higher amounts or more often than prescribed. 
  • It is very dangerous to combine opioids with other drugs, especially those that cause drowsiness. Risk of opioid overdose and death increases at higher dosages, and when taken for longer periods of time or more often than prescribed.
  • Talk to your healthcare provider about any other medications you are using. Work out a plan to call your provider if you continue to experience pain. Also ask about the serious side effects (like excessive sleepiness or craving more of the medication) so you and your family know when to call a doctor or go to the hospital.

Warning signs for someone taking prescribed opioids:

  • Increasing tolerance
  • Running out of pills before its time for a refill
  • Euphoria (feeling high)
  • Mood swings
  • Signs of withdrawal/feeling sick, if a pill is missed

Risk Factors for prescription opioid abuse and overdose:

Research shows that some risk factors make people particularly vulnerable to prescription opioid abuse and overdose, including:

  • Obtaining overlapping prescriptions from multiple providers and pharmacies.
  • Taking high daily dosages of prescription pain relievers.
  • Having mental illness or a history of alcohol or other substance abuse.
  • Living in rural areas and having low income.

 

Pain: Acute vs. Chronic

Prescription opioids can be used to treat moderate to severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness

Alternatives: Non-opioid options include pain relievers like ibuprofen, naproxen, and acetaminophen; acupuncture and/or massage and application of heat/ice. 

Chronic Pain 

Living with chronic pain can be challenging. It is essential that you and your doctor discuss treatment options with all of the risks and benefits carefully considered. Some medications, such as prescription opioids, can help relieve pain in the short term but also come with serious risks and potential complications—and must be prescribed and used carefully. CDC’s Guideline for Prescribing Opioids for Chronic Pain helps increase providers’ ability to offer safer, more effective pain management. The Guideline and supporting resources support clinical decision-making about prescribing opioids.

There is insufficient evidence that prescription opioids control chronic pain effectively over the long term, and there is evidence that other treatments can be effective with less harm.

Acute Pain

Acute Pain is pain that usually starts suddenly and has a known cause, like an injury or surgery. It normally gets better as your body heals and lasts less than three months. For this type of pain, opioid prescriptions should only be taken for the expected duration of pain severe enough to need opioids. Three days or less is often enough; more than seven days is rarely needed.

Opioids for Acute Pain: What you Need to Know (CDC)

Acute pain can be managed without opioids. Ask your doctor or healthcare professional about ways to relieve your pain that do not involve prescription opioids. These treatments may actually work better and have fewer risks and side effects.

Opioids for Acute Pain: Get the Facts (CDC)