Safe Use of Long-Acting Opiates

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Topic Overview

Long-acting opiate pain relievers are medicines used to relieve moderate to severe long-term pain. They are also called extended-release opiates. Opiates relieve pain by changing the way your body feels pain. They don't cure a health problem, but they help you manage the pain.

If you take a lot of short-acting medicine, your doctor may give you long-acting opiates. Long-acting opiates help you avoid the ups and downs in pain relief that you may have with short-acting medicine.

Opiates are powerful medicines. When taken on schedule and as your doctor prescribes, they work well and are safe. But even with proper use, opiates can cause tolerance and overdose, physical dependence, addiction, or death.

  • Tolerance means that, over time, you may need to take more of the drug to keep getting the same amount of pain relief. The danger is that tolerance greatly increases your risk of overdose, breathing emergencies, and death.
  • Physical dependence means your body has become used to having opiates, and you could have withdrawal symptoms when you stop taking them. Symptoms include nausea, sweating, chills, diarrhea, and shaking. But you can avoid these symptoms if you slowly stop taking the medicine as your doctor tells you to.
  • Addiction is a chronic illness that makes you crave a substance, such as a drug or alcohol. When you are addicted to a substance, you have a hard time stopping yourself from using it even when you can see it causes harm.

Examples of long-acting opiates

  • Fentanyl patch (Duragesic)
  • Methadone (Dolophine)
  • Morphine (Kadian)
  • Oxycodone controlled-release (OxyContin)

Safety tips when using long-acting opiates

To avoid taking too much (overdose) of these medicines:

  • Take your medicines exactly as prescribed. Do not take extra doses. Even one extra dose can be dangerous. Taking too much of these medicines can cause death.
  • Be sure to contact your doctor if you miss a dose of your medicine and aren't sure what to do. Do not double your dose.
  • Do not break, crush, or chew a pill. Do not cut or tear a patch.

To use long-acting opiates safely:

  • Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
  • Do not drink alcohol or take illegal drugs.
  • Do not drive or operate machinery until you can think clearly. Opiates may affect your judgment and decision making. Talk with your doctor about when it is safe to drive.
  • Keep your medicine in a safe and secure place away from children and pets.
  • Check with your doctor or pharmacist before you use any other medicines, including over-the-counter medicines.
    • Make sure your doctor knows all of the medicines, vitamins, herbal products, and supplements you take.
    • Taking opiates with other medicines that make you sleepy or relaxed (sedatives) can be dangerous.
  • Talk to your doctor about a naloxone rescue kit. A kit can help you, and even save your life, if you take too much of an opiate.

Possible side effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. You may:

  • Feel confused or have a hard time thinking clearly.
  • Be constipated.
  • Feel faint, dizzy, or lightheaded.
  • Feel drowsy.
  • Feel sick to your stomach or vomit.
  • Have an allergic reaction.

Usually the benefits of the medicine are more important than any minor side effects.

What to know about taking this medicine

  • Opiate pain relievers are strong medicines that can be very helpful in treating pain, especially after an injury or surgery. They are safest when you use them exactly as your doctor prescribes. There is a small risk of addiction when you take opiates. The risk is greater for those with a history of substance use. Others who are more at risk for addiction are teenagers, older adults, people who have depression, and those who take high doses of medicine.
  • Ask for written instructions from your doctor or pharmacist about how to safely get rid of any medicine that's left over.
  • Call your doctor if the dose you are taking doesn't control your pain.

Credits

ByHealthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Nancy Greenwald, MD - Physical Medicine and Rehabilitation

Current as ofMay 20, 2016