Talking to your health care provider about opioids

You may be prescribed an opioid to help manage your pain. Opioids are medications prescribed to treat pain that may have been caused by certain injuries or illnesses. While opioids may not take your pain away completely, they are legitimate medications to be considered as part of your overall pain management strategy.

As with all medications, opioids can have risks and potentially dangerous side effects. If you are prescribed an opioid, it is important to have a conversation with your health care provider – such as your physician, surgeon, nurse practitioner, or sport medicine doctor – to determine if this medication is appropriate for you, and how to use them in the safest way possible.

About opioids

Opioids are medications that are primarily used to treat pain. When taken properly, prescription opioids can help pain patients manage their condition, allowing them to lead full and productive lives. Examples of prescription opioids include:

fentanyl
morphine
oxycodone
hydromorphone
methadone
buprenorphine/naloxone

Some of the medications on the list above (i.e., methadone, buprenorphine/naloxone, hydromorphone) are also sometimes used to treat opioid use disorder ("addiction").

When being prescribed an opioid

You should always follow the instructions given to you by your health care provider, use the lowest dose of opioids possible to control your pain, and take the medication for the shortest amount of time possible. If you are on opioids for an extended period of time (for example, 1-2 weeks), make sure that you are regularly checking in with your health care provider to discuss how the medication is addressing your pain management needs.

It is also important to have discussions with your health care provider about the appropriate dose of opioids to treat your condition and how long you need to take them. When starting an opioid therapy, you should also discuss whether you need to create a plan for when you stop taking this medication, to avoid withdrawal due to suddenly stopping the use of an opioid.

Side effects

The short-term side effects of using opioids may include:

drowsiness
constipation
impotence in men
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

The longer-term side effects of using opioids may include:

increased tolerance (that is, requiring higher doses of the medication to produce the desired effect)
substance use disorder or dependence
liver damage
infertility in women
worsening pain (known as "opioid-induced hyperalgesia")
life-threatening withdrawal symptoms in babies born to mothers taking opioids

Risks

Physical dependence

Continuous use of opioids, including for medical purposes, may lead to physical dependence. This is a natural reaction that may occur in the body when using opioids, particularly when using for an extended period of time (for example, 1-2 weeks). Physical dependence is different from substance use disorder. If opioid use is suddenly stopped, a person may experience symptoms of withdrawal. This may include:

restless sleep
heavy sweating
chills
shakiness
increased pain
twitching, aching muscles
psychological distress

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. If you have been on high doses of opioids, or if you have been taking opioids for an extended period of time, you will need to come off opioids slowly and this process may take several months.

Higher-risk use/Substance use disorder ("addiction")

Opioids can produce 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 higher-risk opioid use.

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

Higher-risk 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 tell your health care provider if you have a history of higher-risk alcohol or drug use, or if you start using opioids improperly.

Overdose

Opioid medications affect the part of your brain that controls your breathing. When you take more opioids than your body can handle (overdose), your breathing slows. This can lead to unconsciousness and even death.

It is important to take your medications as prescribed. Opioids should not be used in combination with alcohol. When using opioids with other medications, you should first consult your health care provider.

Stop taking the medication and get immediate help if you experience any of the following:

severe dizziness
inability to stay awake
hallucinations
heavy or unusual snoring
slow breathing rate

Learn the signs and symptoms of an overdose. If you are taking high doses of opioids or certain other medications that may increase the risk of experiencing an overdose (such as muscle relaxant, sedative, sleep medication), you may wish to have a naloxone kit on hand. This can temporarily reverse an overdose. Naloxone kits are available without a prescription at pharmacies. Ask your pharmacist.

Other treatment options

It is important to discuss with your health care provider how to best control your pain, particularly if you expect your pain could last for more than 1-2 weeks. Opioids may not be the best treatment option for your pain. Other treatment options that do not use opioids or other medication may help you manage your pain. While the availability of some treatment options may vary depending on where you live, it is important that you discuss these with your health care provider to find out what options may be available and appropriate for you. Ultimately, treatment decisions should be made between you and your health care provider.

Questions to ask your health care provider

Any time you get a new prescription opioid medication you should make sure you understand why you are taking it and the instructions on how to take it safely.

Ask your health care provider if you don't know the answer to the following questions:

Why am I being prescribed this medication?
What are the benefits of this medication?
When can I expect to feel better?
How much pain relief should I expect from this medication?
How long should I be taking this medication?
What dose should I take and how often?
Are there any alternatives to opioids 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")?
Are there any interactions with other medications that I am taking?
What should I do if the medication is not working?
When should I return for a follow-up appointment to assess the benefits and potential harms of this therapy?
What is the plan if I feel better and no longer need to take opioids?

Things to tell your health care provider

To advise you properly, your health care provider needs all of the facts. This is the information you should share:

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

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Date modified:: 2023-11-06

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