FAQ – Using Prescription Opioids

Prescription opioids are sometimes used to treat moderate-to-severe pain. Because prescription opioids have several serious side effects and risks, you can ask questions, learn more about opioids, and understand their risks before taking them. Talking openly with your doctor can help ensure you’re getting safe, effective, and the right care for you.

Your clinician should ensure equitable access to effective, informed, individualized, and safer pain management that improves your function and quality of life while working with you to reduce the risks associated with opioid use.

About Opioids

What is the difference between acute, subacute, and chronic pain?

• Acute pain is pain that usually lasts less than 1 month and has a known cause, like an injury or surgery. It normally gets better as your body heals.
• Subacute pain lasts longer than 1 month but not more than 3 months.
• Chronic pain lasts 3 months or more and can be caused by a disease or condition, injury, medical treatment, inflammation, or even an unknown reason.

What are prescription opioids?

Opioids are natural or synthetic chemicals that reduce feelings of pain. Prescription opioids include:

• Hydrocodone
• Oxycodone
• Morphine

What should I consider before taking opioids?

Prescription opioids (opioid therapy) can be used to treat pain, but there is minimal evidence that they are effective for long-term use. If you’re prescribed an opioid, the best approach is to use it only when pain is severe and to stop using it as soon as possible. For most types of acute pain, if opioids are needed, a few days or less are often enough.

Before taking opioid medication for pain:

• Set treatment goals with your clinician for pain and function in your daily life.
• Talk to your doctor about pain treatment options, including ones that do not involve prescription opioids.
• Discuss the risks and benefits of opioid therapy.
• Talk openly with your doctor to ensure you’re getting safe, effective, and the right care for you.
• Tell your doctor about your medical history and if you or anyone in your family has a history of substance use disorders (SUDs).

Risks of using opioids

Will I develop an opioid use disorder?

Anyone who takes prescription opioids can become addicted to them. You may also develop tolerance-meaning that over time you might need higher doses to relieve your pain, putting you at higher risk for a potentially fatal overdose. You can also develop physical dependence-meaning you have withdrawal symptoms when the medication is stopped.

How do I take and store opioids properly?

• Never take prescription opioids in greater amounts or more often than prescribed.
• Avoid taking opioids with alcohol and other substances or medications. It is very dangerous to combine opioids with other drugs, especially those that cause drowsiness, such as:
  • Benzodiazepines (such as Xanax® and Valium®)
  • Muscle relaxants (such as Soma® or Flexeril®)
  • Sleep aids (such as Ambien® or Lunesta®)
  • Other prescription opioids
• Do not share or sell your prescription opioids.
• Store prescription opioids in a secure place, out of reach of others (including children, family, friends, and visitors).
• Dispose of unused prescription opioids at the end of your treatment. Find your community drug take-back program or your pharmacy mail-back program, or flush them down the toilet following guidance from the Drug Disposal: FDA’s Flush List for Certain Medicines | FDA.

Can I avoid the side effects and risks of opioids?

No. Opioids pose a risk to all patients. Anyone taking prescription opioids is at risk for unintentional overdose or death and can become addicted. From 1999 to 2022, nearly 290,000 people died from overdoses involving prescription opioids in the United States.1

In addition to the serious risks of opioid use disorder and overdose, the use of prescription opioids can have several side effects, even when taken as directed.2 Review these with your doctor so you know what you may expect:

• Tolerance-needing to take more of the medication over time for the same pain relief
• Physical dependence-experiencing symptoms of withdrawal when the medication is stopped
• Increased sensitivity to pain
• Constipation
• Nausea and vomiting
• Dry mouth
• Sleepiness
• Dizziness
• Confusion
• Low levels of testosterone that can result in lower sex drive, energy, and strength
• Itching

Remember, your doctor is a partner in your pain treatment plan. It’s important always to let your doctor know about any side effects that you experience or concerns you have about using opioids.

What increases my risk of overdose from opioids and other drugs?

The risk of opioid overdose and death increases at higher dosages and when taken for longer periods or more often than prescribed. It is also very dangerous to combine opioids with other drugs, especially those that cause drowsiness. Overdose risk increases when your opioid medication is combined with:

• Alcohol
• Benzodiazepines (also known as “benzos,” including diazepam [Valium®] and alprazolam [Xanax®])
• Other sedatives like certain sleep medicines and muscle relaxants
• Other opioids (prescription or illicit, including heroin)

Talk to your doctor about any other medications you are using.

Work out a plan to call your doctor if you continue to experience pain. Also, ask about the serious side effects of opioids (like excessive sleepiness) so you and your family know when to call a doctor or call 911.

Anyone who uses opioids can experience an overdose, but certain factors may increase the risk that your clinician can consider when prescribing opioids:

• Having a history of overdose or a substance use disorder
• Having sleep apnea or other sleep-disordered breathing
• Taking higher dosages of opioids (e.g., ≥50 MME/day)
• Returning to a high dose after losing tolerance (e.g., patients undergoing tapering or recently released from prison)
• Taking benzodiazepines with opioids
• Having kidney or liver failure
• Being 65 years and older