You have chronic pain, and your doctor prescribed an opioid, like hydrocodone or morphine. These painkillers can provide relief, but they also come with some concerns.
The difference between a helpful and harmful dose of an opioid is smaller than with other medications, says Lewis Nelson, MD, professor of emergency medicine at the NYU School of Medicine.
What’s more, stopping opioid use may lead to withdrawal symptoms. These can include:
These symptoms can also lead you to become dependant or addicted to the medicine.
These tips can help you stay safe:
1. If you’re concerned, speak up. Ask your doctor if there are other ways to manage your pain, like physical therapy or another type of medication. “Opioids should be the last line of therapy,” Nelson says. You should also let your doctor know if you have a history of substance abuse. That way, they can closely monitor you for any signs of addiction to your new medicine.
2. Work closely with your doctor. Let them know how it’s going and if you have any side effects, like trouble sleeping or drowsiness. Also let them know if your dose doesn’t provide the same amount of relief it once did. This can happen because your body develops a tolerance to the drug. Having a dependence on the medication is also something to let them know about. You’ll know this is happening if you have withdrawal symptoms if you don’t take it.
3. Only take the amount you’re prescribed. When the pain bothers you, it’s tempting to take more. “But increasing your dosage is dangerous,” Nelson says. “It’s not uncommon for someone to overdose by taking an extra pill.” Each day, 44 people in the U.S. die from a prescription opioid overdose.
If you have pain, speak with your doctor. They can adjust your medication and offer advice. For instance, “if you hurt when you clean your house, you may need to pace yourself and work on one room at a time,” says Bill McCarberg, MD, president of the American Academy of Pain Medicine and an assistant adjunct clinical professor at the University of California, San Diego.
4. Never crush or split pills. Some pills are designed to slowly release medicine into your bloodstream. Breaking them up may give you too much at once. “If you have trouble swallowing your pills, speak with your doctor,” McCarberg says. You may need another form of the medicine, like a patch or dissolvable tablet.
5. Be careful about timing. If you forgot to take your medication this morning, don’t double up. This can lead to an overdose. “Just take your next dose at the prescribed time,” McCarberg says. Can’t always remember to take your medication -- or if you’ve already taken it? Get a daily pill case. Some have built-in timers.
6. Watch what else you take. Opioids slow certain body functions, like your heart, Nelson says. So mixing the drugs with alcohol, sleep aids, or muscle relaxers can be dangerous, even deadly. Always tell your doctor if you start another medication while on opioids.
7. Store them safely. Keep your medication away from kids and animals. “In some cases, just one pill can kill a toddler,” Nelson says. Prescription painkiller addiction affects more than 2 million Americans. So you should also put your opioids in a place where others can’t find them. “Don’t keep them in an accessible place, like a medicine cabinet,” McCarberg says. He suggests hiding them in a hard-to-find place or storing them in a lockbox or safe.
8. Don’t share. If a friend complains about an aching back, don’t give them one of your opioid pills. It’s risky -- they may accidentally overdose or could have an opioid addiction -- and it’s against the law. Sharing painkillers is a felony. Instead, tell your friend to see their doctor.
9. Tell family members or caregivers about your prescription and its risks. People around you need to know you’re taking opioids. Also tell them the signs of an overdose, including extreme sleepiness or the inability to wake up, blue fingernails or lips, breathing problems, and tiny pupils. That way, they’ll know to get help in the case of an emergency.
10. Dispose of any unwanted medication the right way. Keeping those extra opioid pills around isn’t a smart idea. “They could fall in the wrong hands, or someone might take them accidentally,” McCarberg says.
Don’t simply toss them in the trash where people can still get to them. Ask your pharmacist about a local take-back program. If your area doesn’t have one of those programs:
- Mix the medicine with inedible things like dirt, kitty litter or used coffee grounds.
- Put it in a sealed plastic bag.
- Throw the bag in the trash.
Before you throw the pill bottle in the garbage, make sure you cross or scratch out everything on the label so that it can’t be read.