Talking to Your Health Care Provider About Opioids (fact sheet)

Opioids are medications that are usually prescribed to treat pain. When taken properly, prescription opioids can help patients experiencing pain manage their conditions, allowing them to lead full and productive lives. However, as with all medications, opioids can come with risks and potentially dangerous side effects.

When being prescribed an opioid

If you are prescribed an opioid, it is important to have a conversation with your health care provider—such as your physician, surgeon, or nurse practitioner,—to determine whether this medication is appropriate for you, and how to use it in the safest way possible. Treatment decisions should be made between you and your health care provider.

If you decide to proceed with the prescription, make sure to:

• always follow the instructions given to you by your health care provider
• use the lowest dose of opioids possible to control your pain
• take the medication for the shortest amount of time possible
• have regular check-ins with your health care provider to discuss how the medication is addressing your pain management needs

Examples of prescription opioids

• fentanyl
• morphine
• oxycodone
• hydromorphone
• methadone

Other treatment options

It is important to discuss how best to manage your pain with your health care provider, particularly if your pain is expected to last more than 1 to 2 weeks. Opioids may not be the best treatment option for your pain. Other medications or treatment options that do not use opioids may be available to help you manage your pain.

Questions to ask your health care provider

• Why am I being prescribed this medication?
• What are the benefits of this medication?
• How long should I be taking this medication for?
• Are there any alternatives to opioids that I could take?
• What are the risks and potential side effects of taking opioids?
• Is there a risk of substance use disorder (addiction)?
• How can I reduce the risks?
• What if I have a history of substance use disorder (addiction)?
• When should I return for a follow-up appointment to assess the benefits and potential harms of this medication?
• What is the plan if I feel better and no longer need to take opioids?

Things to tell your health care provider

• Your complete medical history
• Any concerns you have about taking an opioid
• If you are pregnant or planning to have a baby
• If you are a smoker
• If you are taking other medications, particularly to treat:
  • anxiety
  • seizures
  • sleeping problems
• If you are undertaking other therapies or strategies to manage your pain
• If you have a history of:
  • problematic alcohol or drug use
  • previous or current substance use disorders
  • major depressive disorder
  • generalized anxiety disorder

Potential risks when using opioids

Short-term side effects

• drowsiness
• constipation
• nausea and vomiting
• euphoria (feeling "high")
• difficulty breathing, which can lead to or worsen sleep apnea
• headaches, dizziness and confusion, which can lead to falls and fractures

Physical dependence

Continuous use of opioids may lead to physical dependence. This is a natural reaction that may occur in the body when using opioids, particularly if you are using them for an extended period of time (e.g., longer than 1 to 2 weeks). This is because the body gets used to a regular supply of the drug. If the drug is stopped (withdrawn), or the dose lowered, the body experiences withdrawal symptoms.

Physical dependence is different from substance use disorder. If a person is physically dependent on the drug, it doesn't necessarily mean that they have a substance use disorder. Substance use disorder refers to the continuous use of a drug despite negative consequences.

If you are considering reducing or stopping your opioid medication, it is important to discuss strategies with your health care provider to do so in a safe and effective manner.

Substance use disorder

When someone is affected by substance use disorder, or addiction, they crave the drug and continue using it despite the harmful effects. The drug becomes the focus of their feelings, thoughts and activities.

Opioid use disorder also changes the brain and the body in ways that can make it hard to stop using. This is because the body gets used to a regular supply of the drug.

Problematic opioid use

Opioids can induce euphoria (feeling "high"), increase one's sense of wellbeing and reduce anxiety. These are examples of factors that may lead some individuals to engage in problematic opioid use.

When people think about problematic opioid use, they often think about when someone takes an illegally produced or obtained opioid.

Problematic opioid use also includes:

• Using an opioid medicine improperly, such as taking more than is prescribed or taking it at the wrong time
• Using an opioid medicine that was not prescribed for you

You should notify your health care provider if you start using opioids problematically.

Get the facts at Canada.ca/Opioids