Opioid painkillers: Handle with care

You’ve probably seen news stories about a rise in misuse of prescription opioid pain medications like oxycodone. The U.S. Department of Health & Human Services issued a report warning that the country “is in the midst of a prescription opioid overdose epidemic.”

Opioids are a type of pain medication often prescribed for short-term pain, such as after a serious accident, surgery, dental work, or a broken bone. Sometimes they are prescribed for people living with a health condition like cancer. They dull the body’s ability to feel pain.

Though opioids can be effective at relieving pain, they can also be harmful and dangerous if not taken properly.

“People have the illusion that prescribed medications are always safe,” says Kaitlan Baston, M.D., MSc, medical director of the Addiction Medicine Program at Cooper University Hospital in Camden, New Jersey. “But all medicines have their risks as well as benefits.” It may surprise you to know, for example, nearly twice as many people die of overdose from prescribed opioid medications as from heroin, also an opioid.

Here is some information to help you better understand the risks, benefits, and precautions associated with these drugs.

When are opioids useful?
Opioids are effective and relatively safe for treating short-term pain, such as following a serious injury or recent surgery. They may also be helpful for end-of-life and cancer-related pain. “Those are the only times we should be using them,” Dr. Baston says.

Opioids have not been proven safe or effective for the long-term treatment of chronic pain, as with low-back pain, headaches, or fibromyalgia.

For most people and most types of injuries, opioids should not be taken for longer than three days, says Dr. Baston. It is rare that someone would need more than seven days of opioid medications. People living with cancer or other conditions may be prescribed opioids for longer periods of time. Taking opioids for the shortest time possible helps people avoid tolerance and dependence.

Prescription opioids can have serious side effects even when taken as directed including increased sensitivity to pain, sleepiness, nausea, and constipation.

Ask for the lowest dose
At higher dosages, opioids can cause a variety of problems that affect fertility, immunity, workplace function, and mental health issues. Seniors taking high doses are at an increased risk for falls and fractures. The larger the dose, the greater the risk of opioid use disorder, overdose, and death. Ask your doctor to prescribe the smallest dosage for the shortest amount of time that will be effective, or ask for alternative treatments to opioids when possible. Alternatives include non-opioid analgesics (acetaminophen, for example), nerve pain modulators, ice packs, massage, exercise, and acupuncture.

Warning signs of opioid misuse include taking higher doses than prescribed, falling asleep or breathing slowly after taking medication, and asking more than one provider for a prescription.

Dispose of unused drugs
Store opioids where others will not find them. Most teens who abuse prescription medications receive them from a friend or family member. Give unused pills to a medicine take-back program at a local pharmacy or police station.