Patient Guide

If you have been prescribed a pain medication called an opioid (narcotic), it is important that you are certain that you are taking the medicine in the proper way. If taken in the wrong way, opioids can cause harm or even death.

If opioid use is relieving most of your pain, helping you to live and work more productively and coincides with improved mood and quality of life, it is probably the right treatment. If opioid use is causing your life to spiral out of control, and you are losing function and quality of life, it is probably doing you more harm than good. Know that alternatives are available to treat pain if opioids turn out to be the wrong treatment for you or someone you love.

Possible risks from taking opioids include:

• Addiction
• Drug abuse
• Death from overdose
• Disordered breathing during sleep

Opioids and Addiction

True addiction to prescription opioids is rare. The rate of addiction to all kinds of opiates is only about one percent in the general population and less than four percent in patients with chronic pain who take opioids.

Patients who become addicted to opioids will show the following behaviors:

• Impaired control over drug use
• Compulsive use
• Continued use despite physical, mental or social harm
• Craving

Stress can contribute to abuse. People who are in pain often experience stress about their condition, their financial situation and their relationships with friends and family. If stress becomes overwhelming and opioid use is getting out of control, help is available. A health care provider can supply treatment and coping strategies as well as references to mental health specialists.

Most people who take opioids for pain will not become addicted. Those who do become addicted need treatment. Addicted people are very susceptible to relapse and may return to active abuse even after being clean for some time. People recovering from active addiction may need several rounds of addiction treatment, and it is important not to give up.

Signs of Drug Abuse and Misuse

Some ways people misuse their medications are by:

• Experimenting with them recreationally
• Sharing prescriptions with others
• Taking too much medication to try to control pain
• Mixing prescriptions with substances such as alcohol, recreational street drugs, or other prescriptions, particularly sedatives such as Valium

Young people are especially prone to prescription drug abuse. Drug abuse does not discriminate, however, and older people are also in danger of misusing their medications to mask feelings of depression, anxiety or other problems.

Opioid Medications and Breathing Problems

In some cases, opioid medications can affect breathing. If you or a family member has been prescribed opioid medication, be sure everyone in the household knows the danger signs of respiratory depression. Summon medical help immediately if a person demonstrates any of the following signs while on opioids:

• Snores heavily and cannot be awakened
• Has trouble breathing
• Exhibits extreme drowsiness and slow breathing
• Has slow, shallow breathing with little chest movement
• Has a speeded up or slowed heartbeat
• Feels faint, very dizzy, confused or has heart palpitations

If you have sleep apnea (a condition where breathing temporarily stops) or risk factors for sleep apnea, talk to your doctor about the safety of long-term opioid therapy. It has been observed in up to 75% of patients who take opioids long term for chronic pain. When tranquilizers are added, the risk is heightened with some opioids. So far, there is no evidence patients who take opioids short term – such as after a surgery – are at risk.

Take Only as Prescribed

Opioids provide good pain relief for many short-term and chronic conditions but should not be expected to completely remove all pain. Popping more pills than prescribed to try to relieve all pain is dangerous and counterproductive.

• Never adjust your own doses of opioid medications
• Take your prescriptions only as prescribed and never mix them with alcohol or other sedating substances unless directed by your prescribing physician
• Always tell your health care provider about all medications you are taking
• Keep careful track of when you take all your medications

If you need more pain relief or suffer from additional symptoms such as insomnia or depression, tell your health care provider immediately. He or she will prescribe additional treatments or adjust your dosages to help you get the relief you need.