Important Information About Opioid Medications

When you take opioid medicine:

• Use only enough opioid medicine for a short time to manage acute pain and improve your activity level after an injury or surgery.
• Take nonopioid medicine that you can buy without a prescription as recommended to help decrease your need for opioids. Ask your provider or pharmacist about whether the opioid you take is already combined with these kinds of medicines.
• Taper off opioids as soon as you can to avoid side effects and the risk of addiction.
• Do not take opioids unless specifically told to by your provider.
• Do not drink alcohol while you take opioids.
• Do not take more opioids than you have been prescribed.
• Do not take an opioid at the same time you take other medicines that make you sleepy. Medicines that can make you sleepy include benzodiazepines and muscle relaxants. Ask your health care provider about continuing to take these medicines if you take opioids.
• When you are done taking opioids, you may have some leftover medicine. To help prevent opioid abuse and protect the environment, safely dispose of all unused opioids.

Be sure to talk with your health care provider if you have any concerns about opioids.

About Opioids

Opioids are strong medicines meant to be used to manage pain. They have serious side effects and possible complications, including death. You can become addicted to them. They usually are recommended to manage pain for only a short while.

While you heal, your health care provider can develop a plan to help you manage pain so you can be active in your recovery. If your provider has included opioids in your pain management plan, use the smallest dose needed for the shortest time possible to control symptoms and improve your activity level.

Understanding Pain and How You Heal

Pain is a normal, expected part of the healing process following surgery, procedures, injury and some acute illnesses. Pain lets you know you have had an injury to your body. Having pain does not necessarily mean something is wrong.

Pain is often referred to in the following two ways: acute and chronic.

Acute pain is a sudden, short-term episode of pain. Examples include pain while you heal after surgery or pain from an injury, such as a broken bone. Acute pain gets better naturally as your body heals. It generally lasts only for a few hours or days.

Chronic pain lasts for months or years. It does not necessarily follow the natural pattern of getting better while you heal.

While it is hard to deal with pain, try not to let it overwhelm you. Fear and anxiety can actually make pain worse.

Opioids and Acute Pain

Opioids are most often prescribed for acute pain. Your acute pain management plan usually includes taking opioids for only a short while. Your plan also may include taking nonopioid medicines, such as acetaminophen, and sometimes, ibuprofen or naproxen.

Your health care provider can help set up a plan that shows you:

• The highest number of opioid pills you may take in a given time period.
• How many nonopioid pills you may take in that same time period.
• How much time must pass between taking medicines.
• Examples of how to alternate taking prescription medicines and medicines you can buy without prescriptions.

The amount of medicine listed in your plan for you to take is the MOST you should take. Take only what you need to manage pain so you can do your daily activities.

Your plan usually helps you understand how to lower the amount of opioid medicine you take over time. You might hear this called tapering off a medicine. Your health care provider sets up a plan to show you how to use nonopioid pain medicines as well as other methods to manage pain.

While you take acetaminophen or ibuprofen, make sure you do not take any other medicine that contains acetaminophen or ibuprofen, such as certain cold medicines. Read the packages for ingredients or talk with a pharmacist to be sure.

If you can manage pain without taking opioids, you do not need to keep taking them. Stop taking opioids as soon as possible to limit side effects and lower your risk of becoming addicted.

Expect to have some pain as you take less medicine. Pain management does not mean you have no pain at all.

Talk with your health care provider about the most effective treatments that do not include taking medicine.

• These treatments may include physical therapy, walking, ice, heat or all of these. Treatments also may include structured movement, such as stretching, yoga and tai chi.
• Your health care provider also may suggest other methods meant to help your body heal. The methods may include guided meditation, relaxation and breathing exercises.

Opioids and Chronic Pain

Evidence shows the risk of developing problems caused by opioids goes up every time an opioid prescription is refilled. Taking opioids for a long while can actually make pain last longer and make it more intense.

For these reasons, most health care providers do not recommend taking opioids for chronic pain that is not caused by cancer.

There are many effective treatments to manage chronic pain that do not include taking medicine. Talk with your health care provider about a plan to manage chronic pain.

If you take opioids while you transition to other treatments, your provider closely monitors your opioid use and side effects.

Your provider may have you sign an agreement that lists expectations for taking opioids. This agreement may include:

• Frequent follow-up visits with a health care provider.
• Occasional urine drug tests.
• Occasional pill counts.
• A central monitoring program.

Withdrawal symptoms after you stop taking opioids

Some people who have been taking opioids for a long time have withdrawal symptoms when they taper off opioids quickly or stop taking them abruptly.

These symptoms may include upset stomach, agitation, anxiety, sweating, cravings for the opioid, and diarrhea. For some people, these symptoms can be severe.

To lessen withdrawal symptoms, your provider can set up a plan so you gradually taper off the medicine. Be sure to tell your health care provider about symptoms you have while you do this.

Addiction to Opioids

Addiction is a serious medical condition.

When you are addicted, you become preoccupied with something, such as drugs and alcohol. You may lose control over how much you use them.

The longer you use opioids, the more you risk becoming addicted to them. Even short-term use can result in addiction, especially for those at greatest risk.

Health care providers try to reduce the risk of opioid addiction. They do a thorough evaluation before prescribing opioids, limit the number of pills prescribed and monitor people closely during treatment.

If you are worried you are becoming addicted, talk with your provider right away.

Possible Side Effects of Opioids

Your ability to think clearly and make good decisions may be impaired while you take opioids. For this reason:

• Do not drink alcohol or use any medicines that have not been prescribed for you.
• Do not drive or operate heavy machinery.
• Do not take responsibility for the care of others, such as small children.
• Have someone monitor you for side effects when you first begin taking the opioid.
• Ask your health care provider whether you should work. Many employers have policies about working while possibly affected by medicine. Check with your manager, supervisor or your human resources department to find out more.

Opioids can cause serious side effects. The most common side effect is constipation. You may need to follow certain steps to prevent constipation. This includes taking a laxative medicine.

Other possible side effects include upset stomach, confusion, difficulty sleeping, sexual problems and irritability.

Opioids may be dangerous for people with certain health conditions. Some people are more likely to have breathing problems when they take opioids. These include people who have a heart, lung, liver or kidney condition.

Healthy people also can have these breathing problems if opioids are not taken correctly. These breathing problems can lead to death.

Before you take an opioid, tell your health care provider about all your current medical conditions and medicines. Carefully follow the directions your health care provider gives you about taking opioids.

Opioid Storage and Safety

All medicines can be dangerous when taken by someone for whom they are not intended. It is your responsibility to keep medicines in a safe place.

Keep your medicines out of the reach of others. Take steps to protect teens, children, vulnerable adults and pets.

Think carefully about where you place a container of opioids. Consider keeping the container in a locked location. Do not leave opioids on a counter, in a purse or a bag where someone else could easily get them.

Destroy unused opioid medicine

In the past, when health care providers prescribed larger quantities of opioids, they found most people had medicine left over. People kept the medicine “just in case.” This can be dangerous for several reasons:

• It is not safe for you to use the medicine in the future when your medical condition and medicines may have changed.
• Someone else may try to take your medicine. It is not safe for people to take medicine that was not prescribed for them.

Once you are done taking an opioid, safely dispose of the unused medicine by following one of these steps:

• Call your local city offices, police department or hospital to ask about 24/7 boxes where you can drop off unused drugs.
• Remove the unused medicine from the bottle and mix it with something that no person or animal would want to eat, such as cat litter or coffee grounds. Place the mixture in a sealed, plastic bag, and throw the bag in the trash.
• Buy special bags that you can use to throw out medicines. They are called deactivation disposal bags. An example of these are Deterra bags. You can buy them at many pharmacies.
• If you are not able to use any of these methods to dispose of opioid medicine, the Food and Drug Administration recommends that you flush your medicines down the toilet. It is safer to do this than to keep them in your home.

Safe storage and disposal of opioids are very important to prevent addiction and death.

Remember These Points About Pain and Opioids

• Expect to have some pain while you heal.
• Begin to take fewer opioids as soon as you can.
• Rely on your health care team to help you manage pain.

This material is for your education and information only. This content does not replace medical advice, diagnosis or treatment. New medical research may change this information. If you have questions about a medical condition, always talk with your health care provider.