Opioids and Pain Management
Pain is a distressing sensation that many of us experience on a daily basis as a result of incidents such as cuts, burns, accidents, and countless other reasons. Pain can range from acute to chronic and severe. How we deal with pain has changed over the past couple of decades. There has been a large increase in the prescribing and use of opioid medications for acute and long term chronic pain (lasting more than 3 months). Retail pharmacies across Canada dispensed 19 million prescriptions for opioids in 2016 and overdoses and deaths have seen a sharp increase. In 2015, 734 people died in Ontario as a result of opioid use, a four fold increase since 1991. It is therefore important to be aware of the important side effects and risk of opioids and safer ways to manage pain.
Opioids and Their Side Effects
Opioids are strong narcotic medications that relieve pain by acting on receptors in the brain and spinal cord. Opioids, such as oxycodone, hydrocodone, and morphine, have many short term and long term side effects. Short term side effects include drowsiness, constipation, nausea, vomiting, headaches, dizziness, confusion, difficulty breathing, euphoria, itching and sweating.
Long-term effects include increased tolerance to the medication (increased dose of medication needed to see the same effect), dependence, and withdrawal symptoms.
Opioids can have serious risks including severe breathing problems, addiction, overdose, and even death. These risks are more likely when combined with alcohol, medications, or other substances. As many as 1 in 4 patients receiving opioids for chronic pain develop addiction. Signs and symptoms of overdose include slow or weak breathing, dizziness, confusion, drowsiness, cold and clammy skin, very small pupils, collapse, and coma.
Non-Opioid Options and Safer Pain Management
Studies have shown that opioids only result in a small improvement in pain and function when added to non-opioids in patients with chronic therapy. It is first recommended to maximize the use of non-opioid medications (such as Tylenol and Advil) and therapy unrelated to medication such as exercise and behavioral therapy as they can be effective with less harm to the body. If opioids are needed to manage your pain, it should only be considered after weighing the major benefits and the risks. It is very important to not take opioids with alcohol and other substances or medications without first discussing it with your doctor to avoid major interactions. Also, it is essential that you never take opioids more often than prescribed by your doctor.
Talk to your Health Care Professional
Your pharmacist and doctor are excellent resources when considering which pain medications to use for acute and long term pain. Consider all the facts and information so you can make an informed decision with your doctor.
- Gomes T, Greaves S, Martins D, et al. Latest Trends in Opioid-Related Deaths in Ontario: 1991 to 2015. Toronto: Ontario Drug Policy Research Network; April 2017.
- Prescriptions for painkillers still rising in Canada despite opioid crisis (2017, March 29). Retrieved from http://www.theglobeandmail.com/news/national/prescriptions-for-painkillers-still-rising-in-canada-despite-opioidcrisis/article34431838/
- Busse, J, et al. 2017 National Draft Recommendations for Use of Opioids. McMaster National Pain Centre; January 2017
- Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. JAMA.
- CPhA Monograph. Canadian Pharmacists Association (2016)
- Dowell, Haegerich, T; Chou, R. CDC Guideline for Prescribing Opioids for Chronic Pain. Atlanta: Centers for Disease Control and Prevention; March 2017
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This article was provided by the clinical pharmacy at Rx Infinity. Rx Infinity provides optimal and sustainable patient management solutions through customized programs, innovative technology and added value services that improve the overall patient experience; while helping payers and plan sponsors achieve sustainability in the management of drug plans expenditures.
This information is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions about your medical condition. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.