Answers to your opioid questions
4/27/2017 by Dr. Lynne Lillie
Hardly a day goes by when opioids aren't in the news. And with good reason. Every day across the U.S., 40 to 50 people die from opioid abuse. But these medications also provide a valid option for pain treatment. We get a lot of questions from patients about opioids; these answers may help you better understand them.
Q: What are opioids?
A: This is a category of drugs used to relieve pain by acting on the central nervous system. They can cause both mental and physical dependence or addiction - often as soon as three days - and may lead to other side effects when you quit taking them. Common names for some opioids are codeine, Norvo, Vicodin, oxycodone and OxyContin.
Q: What are they prescribed for?
A: Opioids are most often prescribed to treat acute pain and occasionally prescribed for chronic pain. Acute pain is short lasting, generally only days or sometimes for a couple of weeks. You might feel acute pain when you have an illness, injury or surgery. Chronic pain is persistent, lasting for months or even longer. Chronic pain is complex and considered a health condition on its own.
Q: Are there guidelines for prescribing them?
A: Under the new guidelines from the Centers for Disease Control and Prevention (CDC), opioids shouldn't be used to treat acute pain for more than three days. Alternatives to relieve acute pain include rest, elevation, icing and other non-opioid relievers such as acetaminophen, ibuprofen and aspirin. Mayo Clinic is in the process of developing a new policy for prescribing opioids.
Q: With the opioid epidemic across the country, are doctors thinking differently about prescribing opioids?
A: The short answer is, "yes." Research is teaching us there are many side effects associated with long-term use of opioid pain medications for chronic pain. Over time, the medications can have decreased effectiveness as the body develops tolerance to the medication, and what used to provide relief, doesn't work anymore.
Other side effects can include increased sensation of pain and illness associated with withdrawal of the medication. These symptoms can lead to medication dependence and more seriously, medication addiction. It is very important that your provider monitor you for signs of tolerance, dependence or possible addiction to pain medications.
It is also important to know that the goal of medication treatment is to lessen pain and help a person continue functioning with their usual daily activities, so while we can't always make a person completely pain free, we can help people with chronic pain live better lives. We do this by treating the whole person and help our patients manage pain so they can live the best life possible. That means being able to get up, get dressed, go to work, take care of your kids, enjoy social activities and even physical exercise. If you have chronic pain, you and your provider should develop a pain-management plan that spells out goals and how to achieve them.
Q: What if I'm worried about becoming addicted to a pain medication?
A: Talk with your provider. Many patients feel they'll be judged and considered "bad" because they have a problem. They also fear that going off the medication will cause a level of pain that won't allow them to function. Your provider can describe what withdrawal and tapering off a drug will be like, so you'll know what to expect. They'll also create a plan using various medication and non-medication techniques for managing pain.
Realize that we understand that you have real pain and that we're trying to help you do what's best for your overall health.
Q: How should opioids be stored?
A: If you're given a prescription for an opioid, be very aware of where you are storing it and who might have access to it. One of the biggest dangers is that someone who hasn't been prescribed the drug will take it - or sell it. This could be another family member, child or grandchild, putting them in danger of overdosing. Try to store any prescription drugs in a secure place, especially one out of reach of children.
Q: I didn't take all the pills I was prescribed. How do I dispose of them?
A: The Olmsted County Sheriff's Department has a secure drop-off box for unused prescription drugs in the lobby of the Adult Detention Center at the Olmsted County Government Center, 151 4th St. SE in Rochester. You may drop off drugs 24/7/365. Also, you may want to check if there is a drug-disposal location or event in your community.
Dr. Lynne Lillie is a senior associate consultant and assistant professor of Family Medicine with Employee and Community Health (ECH) and has been a full-time practicing physician for over 20 years. She currently serves on the national board of directors for the American Academy of Family Physicians. One of her areas of focus on the board is opioids. Read her interview in the Winter 2017 issue of Minnesota Family Physician.