Safe Opioid Use

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, people who take opioids are at risk for opioid use disorder (OUD) and overdose. These risks increase when opioids are misused. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

How do I know if I need to take opioid medicines?

First, you need to talk with your provider about whether you need to take opioids. You should discuss:

• Whether there are other medicines or therapies that might treat your pain
• The risks and benefits of taking opioids
• Your medical history and if you or anyone in your family has a history of substance misuse, a drug addiction, or alcohol use disorder (AUD)
• Any other medicines and supplements you are taking
• How much alcohol you drink
• If you are pregnant or planning to become pregnant

What do I need to know if I am going to take opioid medicines?

If you and your provider decide that you need to take opioids, make sure that you understand:

• How to take the medicine - how much and how often.
• How long you will need to take the medicine.
• What the possible side effects are.
• How you should stop the medicines when you no longer need them. If you have been taking opioids for a while, it can be dangerous to just stop suddenly. You may need to get off the medicines slowly.
• What the warning signs of addiction are, so you can watch for them. They include:
• Regularly taking more medicine than you are supposed to
• Taking someone else's opioids
• Taking the medicine to get high
• Mood swings, depression, and/or anxiety
• Needing too much or too little sleep
• Trouble making decisions
• Feeling high or sedated

If you have a high risk for an overdose, you will want to get naloxone from a pharmacy and carry it with with you wherever you go. Naloxone is a medicine that can reverse the effects of an opioid overdose.

How can I take my opioid medicine safely?

You should always be careful when taking any medicine, but you need to take extra care when taking opioids:

• Take your medicine exactly as prescribed - do not take extra doses.
• Check the instructions every time you take a dose.
• Do not break, chew, crush, or dissolve opioid pills.
• Opioids can cause drowsiness. Do not drive or use any machinery that may injure you, especially when you first start the medicine.
• Contact your provider if you have side effects.
• If you can, use the same pharmacy for all your medicines. The pharmacy's computer system will alert the pharmacist if you are taking two or more medicines that could cause a dangerous interaction.

How can I safely store and dispose opioid medicines?

It is important to store and dispose of opioid medicines properly:

• Store your opioids and other medicines in a safe place. If you have children at home, it's a good idea to store your medicines in a lockbox. Even one accidental dose of an opioid pain medicine meant for an adult can cause a fatal overdose in a child. Also, someone who lives with you or visits your house may look for and steal your opioid medicines to take or sell them.
• If you travel, carry the current bottle of opioids with you for safety. This will help you answer any questions about your medicine.
• Dispose of your unused medicine properly. If you have unused opioid medicines at the end of your treatment, you can get rid of them by:
• Finding a local drug take-back program
• Finding a pharmacy mail-back program
• In some cases, flushing them down the toilet - check the Food and Drug Administration (FDA) web site to find out which ones you can flush away
• Never sell or share your medicines. Your prescription is for you. Your health care provider considers many factors when prescribing opioids. What's safe for you might lead to an overdose for someone else.
• If someone steals your opioid medicines or prescription, report the theft to the police.

Questions for your care team

General prompts to help prepare for your appointment.

• How does this information apply to my situation?
• Which symptoms or results need evaluation?
• Which tests are useful, and what can they tell us?
• What care options, benefits, and risks should we discuss?
• When should I seek urgent help, and whom should I call?
• When is follow-up, and how will we know whether the plan is working?