Thinking About Taking Opioids for Pain?

Are you thinking about taking opioids (painkillers) for your pain?

For a printable copy of this document please download this PDF file.

Review this information and talk to your doctor to see if painkillers are right for you. Opioids can be one part of a safe and overall pain plan, but they require care. If you and your doctor decide that they are right for you, then both of you will set goals to look at your pain, side effects and daily function.

Opioids can be one part of a safe and overall pain plan but they require care. Take this document to your next doctor’s visit to help guide the conversation.

Opioids

  • They are commonly called analgesics or painkillers that help with moderate to severe pain.
  • Names of some painkillers include: Tylenol 3®, Percocet®, OxyNEO®, Tramacet®, Methadone, Morphine, Fentanyl, and Hydromorphone.
  • Because they are a controlled substance, doctors are required to carefully monitor patients' use.

Pain Killers Reduce Pain By

  • Decreasing reaction to pain, and increasing ability to put up with pain.
  • Improving how you function and carry out your daily activities.
  • Pain relief for most people will not be complete and may be as little as 30% base pain relief in some people; although we hope for more.
  • People will take opioids for various reasons and may be on opioids for different lengths of time.

Side Effects

  • Can be decreased by starting at a low dose and increasing it slowly under your doctor’s direction.
  • Include: nausea, vomiting, constipation, drowsiness, dizziness, dry-skin or itching, and dry-mouth.
  • Can become manageable as your body adjusts. For example, to minimize constipation, increase fiber intake (by eating more fruit, vegetables, whole grains), water and exercise.
  • Discuss the potential risks of long-term use of opioids with your doctor.
  • If you are thinking about going off opioids speak with your doctor.

Concerns about Dependency

  • Being dependent on a painkiller means that your body is used to how the medicine affects the pain.
  • Being addicted to a painkiller means that you are abusing or misusing the medicine for reasons other than pain relief.
  • Your doctor will talk to you about any concerns you may have about dependency.
  • Over time, your body may get used to the dose of the painkiller you are taking.

Avoiding Risks to Yourself

  • Take the medication exactly as your doctor instructs.
  • Only one doctor should be prescribing your painkillers to make sure you are meeting the goals that you both set.
  • You should fill your prescriptions at the same pharmacy.
  • Urine and blood screening may be used to identify potential problems.

Avoiding Risks to Others

  • Do not share your painkillers with others or change your prescription in any way - it is against the law and could seriously harm or kill them.
  • The doctor's prescription should be taken safely to a pharmacy as soon as possible.
  • Keep your painkillers securely stored at home in a locked box or cabinet to prevent accidental poisoning, or being taken by others for misuse.
  • Return unused medications to the original pharmacy.

Avoiding Withdrawal Symptoms

  • Symptoms will occur if you stop using your painkillers.
  • These can be uncomfortable and include nausea, diarrhea, chills, and flu-like symptoms.
  • Your body has become used to the medication so the dose must be decreased slowly under your doctor’s direction before being stopped.

Avoiding Overdose

  • Painkillers can be safe over long periods of time. But they can be dangerous when you start or increase a dose.
  • Avoid mixing painkillers with alcohol or other drugs since this increases the risk of overdose.
  • Overdose means taking too much medication and can result in your inability to think clearly and your breathing could slow down or stop. This may cause brain damage, coma and death.
    • If you or your family members notice: slurred or drawling speech, becoming upset or crying easily, poor balance, or "nodding off" during conversation or activity contact your doctor.
    • If you or your family members notice: extreme sleepiness or difficulty to rouse call 911.

Travel

  • Keep your painkillers in the original container from the pharmacy.
  • If you fly, keep your painkillers with you in your carry-on luggage.
  • It is helpful to bring a letter from your doctor explaining your need for painkillers, especially if you are going outside of your province or territory.

What to Expect

  • Using only medications will not take away your pain.
  • Speak with your doctor about other healthcare options such as physiotherapy, speaking with a psychologist.
  • Using coping strategies such as yoga, meditation and positive self-talk may help to reduce pain.

For more information visit http://prc.canadianpaincoaltion.ca and http://nationalpaincentre.mcmaster.ca

This document was prepared by the Michael G. DeGroote National Pain Centre, January 2014.