5. Frequently Asked Questions about opioid safety.

• Should I stop using all other pain relievers when taking opioids?
• Is it best to take as little of the opioid medicine as possible?
• Do I really need to avoid all alcohol while taking opioids?
• Can I drive a car while taking opioid pain relievers?
• I have no place to lock up my opioid medicines - what can I do?
• What is wrong with sharing a small amount of opioids with a friend or relative?
• Why is it unsafe to open capsules or crush tablets to make taking opioids easier?
• Could I eventually become addicted to opioid pain relievers?
• What if the opioid medicine stops helping my pain after awhile?
• What causes opioid withdrawal?
• What if I am running out of opioids before my next appointment?
• When can I stop taking the opioid medicines?
• I hear that opioids cause constipation - what can be done?
• What if I become pregnant while taking opioid medicines?
• Why should I always use the same pharmacy to fill opioid prescriptions?
• There is an awful lot to remember about opioid safety - what should I do?
• What if I cannot afford to buy the prescribed opioid medicines?

 

Should I stop using all other pain relievers when taking opioids?

Opioid pain relievers may be all that you need to take; however, this should be decided between you and the healthcare provider who prescribes opioids for you. Be certain to tell the prescriber and your pharmacist about all medicines and other substances you have been taking, whether or not for pain. This includes over-the-counter products, herbs, and vitamins. Also, it is very important for your safety that the healthcare provider know the amount of alcohol you drink and if you have been using marijuana or "street drugs."

Back to Top of FAQs

 Is it best to take as little of the opioid medicine as possible?

 The best amount of opioid medicine to take is exactly what was prescribed for you. Skipping regularly scheduled doses when your pain is weaker, or sometimes taking less medicine than prescribed to make it last longer and save money, could result in your pain getting out of control. If this happens, taking more than the prescribed amount to relieve the pain could be dangerous. Always take opioids that were precribed for use "as needed" or for breakthough pain according to the prescriber's instructions. If your opioid medicine is not working for you the way you would like it to, or its cost is straining your budget, talk to your healthcare provider about your concerns.

Back to Top of FAQs

 Do I really need to avoid all alcohol while taking opioids?

 Drinking any alcohol - whether beer, wine, or hard liquor - while using opioid medicines can be very dangerous. Even small amounts of alcohol can increase opioid sedative effects, making you feel drowsy, confused, or dizzy. You could easily fall and hurt yourself. Too much alcohol combined with opioids can cause drug overdose and possibly kill you. And, it is impossible to know in advance how much is "too much" alcohol. At the least, if you still want to have an occasional drink while taking opioids, discuss it first with your healthcare provider.

Back to Top of FAQs

 Can I drive a car while taking opioid pain relievers?

 When first starting an opioid medicine, or after a dose increase, you should avoid driving a car or operating any potentially dangerous equipment, such as a lawnmower or power tools. This is for your own safety as well as to protect other persons. Until your body becomes accustomed to the opioids you may feel sleepy, less alert, and have slower reaction times, which can result in serious accidents. After awhile, you will probably be able to drive again and operate equipment, but you should ask your healthcare provider about this whenever opioids are being prescribed or the dose is being changed. It is important to remember that you may have poorer ability to drive or perform other tasks that require attention and skill even if you do not feel sleepy or otherwise different.

Back to Top of FAQs

 I have no place to lock up my opioid medicines - what can I do?

 While it may seem inconvenient to keep medicines locked up, you need to safeguard your opioids as you would your jewelry or money. Other persons who you least suspect - visitors or workers coming into your home, friends, or even close family - may look for opioids that they can use for their own pain, or abuse to get "high," or sell to others. Children or pets may innocently get into opioids that are not locked away and poison themselves. You could be a source of drugs that seriously harm others, and you will not have the medicine you need for pain.

Look around your home; perhaps, there is a locking drawer or file cabinet where you can store your opioids. If not, many hardware and office supply stores sell locking metal boxes (sometimes called "cash boxes"). You also can purchase special locking containers for medicines on the Internet <click here for sources>. Be certain to share an extra key or the lock combination with someone you trust.

Back to Top of FAQs

 What is wrong with sharing a small amount of opioids with a friend or relative?

 There are at least four reasons for never sharing opioids with others, whether it is for their pain or other reasons:

(1) A single opioid capsule, tablet, or patch could kill someone who is not used to taking the drug;

(2) Even if the person has their own prescription for an opioid pain reliever, your particular opioid and the dose may not be the same and could make them very sick;

(3) By sharing, you may run out of your opioid medicine sooner and not be able to get a refill to treat your pain;

(4) It is against the law to share opioids with others, whether for free or for money - it is considered illegal drug diversion and you could be arrested.

Many people believe, correctly, that the police are not peeking in their windows to see if they are sharing opioids with others. However, if a person is harmed from the "borrowed" opioid and ends up in the emergency room or dead, the police will be asking where they got the drug - and you are the offender. So, you are not doing the other person, or yourself, a favor by sharing even a small amount of your opioid medicine, and you could accidentally do them great harm.

Back to Top of FAQs

 Why is it unsafe to open capsules or crush tablets to make taking opioids easier?

 If you have trouble swallowing solid medicines discuss this with your opioid prescriber. Most opioid medicines are made to deliver a specific amount of the drug during a specific period of time. Opening capsules or crushing tablets of opioids may give you too much opioid in too short a time, which can make you sick or cause harmful overdose. There are liquid formulations of many opioids, and there are certain opioids that can be opened, cut, or crushed, but you need to check first with your opioid prescriber or pharmacist for directions. Also, if you have been prescribed opioid patches, they should never be cut - applying only part of a patch could release too much of the medicine too quickly into your body and be very harmful.

Back to Top of FAQs

 Could I eventually become addicted to opioid pain relievers?

 Many persons who must take opioid medicines for some time are afraid that they will become drug addicts. However, current best evidence suggests that this seldomly happens IF the opioids are taken for pain relief and exactly as instructed by the opioid prescriber. Addiction is actually a physical and mental disease that may develop if a person wrongly uses opioids to feel "high" or to change their mood rather than for pain relief. After awhile, the person loses control and cannot stop abusing opioids, even though it is not helping their pain and is ruining their work or school, social, and family lives.

Addiction is not a natural side effect of taking opioid pain relievers. It is more likely to occur in a person who has had substance abuse or addiction problems in the past (including alcoholism). Or, since it can be hereditary, you may be more likely to develop addiction if close family members have had problems with drugs or alcohol. You should tell your opioid prescriber if you or a family member has had such problems. You can still be prescribed opioids for pain, but certain precautions can be taken to help protect you from becoming addicted to the medicine. Opioid addiction is often confused with tolerance to the medicine or physical dependence on it, and these conditions are discussed in the next two questions. Also, you can <click here> for more information on addiction.

Back to Top of FAQs

 What if the opioid medicine stops helping my pain after awhile?

 Over time, as your body gets used to the opioid medicine, it may not seem to provide the same amount of pain relief. It is possible that your pain condition has gotten worse, or you may have developed tolerance to opioid pain-relieving effects. That is, it seems to take more opioid to provide the same amount of pain relief. This does not always happen and it does NOT mean that you have become addicted to the medicine. Your healthcare provider may instruct you to take more of the opioid or take it more often. However, never change the dosing on your own, as this could be dangerous. In some cases, the prescriber may switch you to a different opioid medicine - fortunately, there are many different types of opioids available.

Back to Top of FAQs

 What causes opioid withdrawal?

 As your body gets used to a steady amount of opioid medicine each day, you may become physically dependent on it. In that case, suddenly reducing the amount or stopping the medicine entirely can cause "withdrawal." This also can occur if you start taking another medicine that reduces effects of the opioid - called a "drug interaction." Opioid withdrawal typically is not harmful, but it can feel quite unpleasant and even painful - somewhat like having a very bad case of the flu. Physical dependence and withdrawal can naturally occur after opioids are taken for some time and, by themselves, are NOT signs of addiction. Uncomfortable withdrawal can be avoided if the opioid dose is very gradually reduced over time, as directed by your opioid prescriber. For more information on what withdrawal is like <click here>, and be sure to tell your healthcare provider if you start having withdrawal signs or symptoms.

Back to Top of FAQs

 What if I am running out of opioids before my next appointment?

 The important question you will be asked is, "Why are you running out early?" There are at least four situations to consider:

(1) Did your pain get worse and you took more opioid medicine than was prescribed? You should call your opioid prescriber before changing the dose on your own.

(2) Was your opioid medicine lost or ruined for some reason? You should call the prescriber right away if that happens.

(3) Was your opioid medicine stolen? You should file a police report, get a copy of the report, and then call the opioid prescriber.

(4) Did you share part of your opioid medicine with someone else? You should never do this as it might harm or even kill the other person, and it is against the law.

Remember, you are responsible for taking your opioid medicine only as prescribed and keeping it safe. So, depending on what happened, your prescriber may be concerned that you are not following directions or protecting the opioids as you should. You might not receive a refill before your next scheduled appointment. For advice on how to deal with running out of opioid medicine before your prescription can be refilled or if you cannot get prescription refills after a disaster - for example, a hurricane, flood, earthquake, or fire - or for some other reason <click here>.

Back to Top of FAQs

 When can I stop taking the opioid medicines?

 As long as opioids are helping to control your pain, and you have a better quality of life because of it, you may need to continue taking the medicines for an indefinite period of time. Taken as directed, along with proper medical care, opioids have a good safety record. On the other hand, persistent pain without any relief can be harmful physically and mentally. At some point, you may want to reduce or stop the opioid to see if your pain is still there or bearable without the medicine; however, talk to your healthcare provider about this first. If you stop taking opioids on your own you may suffer uncomfortable withdrawal.

Back to Top of FAQs

 I hear that opioids cause constipation - what can be done?

 Constipation - having irregular or difficult bowel movements - is a common problem with all opioid medicines. Opioids naturally slow the movement of food through the intestine and bowel; although, some people are more bothered by this than others. You should ask your healthcare provider about constipation whenever opioids are being prescribed, and be sure to mention if you already have constipation. Diet and exercise can help ease constipation and there are prescription medicines that can help. You can also ask your pharmacist about an over-the-counter product to ease constipation due to opioids. Do not select a product on your own without getting professional advice, since some products can make opioid-related constipation worse.

Back to Top of FAQs

 What if I become pregnant while taking opioid medicines?

 Tell your opioid prescriber if you are planning to get pregnant or as soon as you think you may be pregnant. Some studies suggest there is a very small chance of a baby having certain birth defects if the mother takes opioids early in pregnancy. In most cases, opioids do not harm the developing baby if taken exactly as prescribed for pain, but the type of opioid or the dose may need to be changed so that the baby is not born dependent on opioids with uncomfortable withdrawal symptoms. In some cases, you and the prescriber may decide on another medicine or approach for relieving your pain.

Back to Top of FAQs

 Why should I always use the same pharmacy to fill opioid prescriptions?

 Getting all of your prescriptions filled at the same pharmacy - or the same chain of pharmacies if they are linked by computer - is for your safety and convenience. That way the pharmacist will know of all medicines that you are taking and will notice if any of them may not work well together or be harmful when taken together. Also, once they know of your regular prescriptions, most pharmacies will be certain to keep the medicines that you need, including opioids, in stock and some will alert you before it is time for refills.

Back to Top of FAQs

 There is a lot to remember about opioid safety - what should I do?

 Yes, there is a lot to remember. However, once you learn the basic "rules of the road" when it comes to opioid safety, you also should be able to use your other medicines more safely to help protect yourself and others. As a handy reminder, <click here> to download and print a one-page opioid safety information sheet. Be sure to also share it with family or friends who help to take care of you. And, regularly come back to this Opioids911-Safety program to refresh your memory.

Back to Top of FAQs

 What if I cannot afford to buy the prescribed opioid medicines?

 Paying for medicines, including opioid pain relievers, can be difficult for many patients, whether or not they have some form of healthcare insurance. However, help is available for those who look for it. For one thing, there are Patient Assistance Programs, or PAPs, run by pharmaceutical companies, which provide free medicines to people who cannot afford to buy them. In the United States, there also are many federal, state, and local programs offering help with the costs of medicines for families and individuals needing assistance. At the least, there are organizations offering discount cards free of charge that provide large savings on medicines at participating pharmacies. Here are several websites based in the USA that are worth looking into:

 RxAssist.org - this website has an extensive list of PAPs, offers a prescription discount card, and has worthwhile articles and other information for healthcare professionals and patients. (USA Phone: 401-729-3284.)

 NeedyMeds.org - provides a free drug discount card and links to PAPs, government programs, and other helpful resources.

 Medicine Assistance Tool - provides a single point of free access to 475+ public and private assistance programs, including nearly 200 offered by pharmaceutical companies. (USA Phone: 888-477-2669.)

 RxHope.com - offers personalized assistance online for use by healthcare providers and their patients in applying to the various PAPs for aid. (USA Phone: 877-267-0517.)

Examine all 4 websites to see which might be best for your needs. Drug discount cards are available right away. However, applying for assistance programs will require you to fill out some paperwork, and you also may need the support of your opioid prescriber to qualify. It can take some weeks before assistance is provided, so you should seek help right away if you think you will be needing it.

Back to Top of FAQs

Return to Home Page