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Opioid (Narcotic) Pain Medications When you have a mild headache or muscle ache, an over-the-counter pain reliever is usually enough to make you feel better. But if your pain is more severe, your doctor might recommend something stronger -- a prescription opioid. Opioids are a type of narcotic pain medication. They can have serious side effects if you don't use them correctly. For people who have an opioid addiction, their problem often started with a prescription. If you need to take opioids to control your pain, here are some ways to make sure you're taking them as safely as possible. How Opioids Work Opioid drugs bind to opioid receptors in the brain, spinal cord, and other areas of the body. They tell your brain you’re not in pain. They are used to treat moderate to severe pain that may not respond well to other pain medications. Opioid drugs include: Codeine (only available in generic form) Fentanyl (Actiq, Abstral, Duragesic, Fentora) Hydrocodone (Hysingla, Zohydro ER) Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin) Hydromorphone (Dilaudid, Exalgo) Meperidine (Demerol) Methadone (Dolophine, Methadose) Morphine (Kadian, MS Contin, Morphabond) Oliceridine (Olynvik) Oxycodone (OxyContin OxyContin, Oxaydo) Oxycodone and acetaminophen (Percocet, Roxicet) Oxycodone and naloxone Your doctor can prescribe most of these drugs to take by mouth. Fentanyl is available in a patch. A patch allows the medication to be absorbed through the skin. Working With Your Doctor You'll need a prescription from your doctor before you start taking opioids. The doctor can adjust the dose as needed to help control pain. You may receive around-the-clock doses to manage pain throughout the day and night. And your doctor may prescribe opioids to be taken "as needed" in case you have "breakthrough" pain -- a flare of pain that you get despite round-the-clock doses. While you're on opioid pain medications, check in with your doctor regularly. Your doctor will need to know: How your pain is responding to the drug Whether you're having any side effects Whether you have any potential interactions or medical conditions that could make you more likely to have side effects, such as sleep apnea, alcohol use, or kidney problems Whether you're taking the drug properly Never change or stop taking any opioid medicine without first checking with your doctor. If a pain medication isn't working as well as it should, your doctor may switch you to a different dose -- or add on or try another drug. When you're ready to stop taking opioids, your doctor may help wean you off them slowly -- if you have taken them for a long time -- to give your body time to adjust. Otherwise, you may have withdrawal symptoms. Opioid Side Effects One of the reasons why your doctor needs to manage pain medications so closely is that they can cause side effects, such as: Constipation Drowsiness Nausea and vomiting The drugs lubiprostone (Amitiza), methylnaltrexone (Relistor), naldemedine (Symproic), and naloxegol (Movantik) are approved to treat constipation due to opioid use in those with chronic pain. Opioids can be dangerous if you take them with alcohol, or with certain drugs such as: Some antidepressants and anxiety medications (particularly benzodiazepines such as alprazolam, Ativan, and clonazepam) Some antibiotics Sleeping pills Make sure your doctor knows all of the other medicines you're taking. That includes: Prescription drugs Over-the-counter drugs Herbal supplements Opioid Tolerance and Addiction After taking opioid pain medication for a while, you might find that you need more and more of the drug to achieve the same effect in easing pain. This is called tolerance. It's not the same as addiction, which involves the compulsive use of a drug. When you use opioid medication over an extended period of time, you can have dependence. This can happen when your body becomes so used to the drug that if you abruptly stop taking it, you get withdrawal symptoms such as: Diarrhea, nausea, and vomiting Muscle pain Anxiety Irritability You can also get a serious addiction to opioid pain medications. People who are addicted compulsively seek out pain medications. Their behavior usually leads to negative consequences in their personal lives or workplace. They might take someone else’s pills or buy them off the street, which is especially dangerous since those drugs are often laced with lethal amounts of fentanyl. Learn more about what can happen when opioid addiction goes untreated. If you are having a problem with addiction, you need to see your doctor or an addiction specialist. Should You Take Opioid Pain Medications? Opioids can make a dramatic difference to people with moderate to severe pain. These drugs can be an effective therapy -- as long as you use them safely and follow your doctor's instructions carefully. Opioid addiction is a long-lasting (chronic) disease that can cause major health, social, and economic problems. Opioids are a class of drugs that act in the nervous system to produce feelings of pleasure and pain relief. Some opioids are legally prescribed by healthcare providers to manage severe and chronic pain. Commonly prescribed opioids include oxycodone, fentanyl, buprenorphine, methadone, oxymorphone, hydrocodone, codeine, and morphine. Some other opioids, such as heroin, are illegal drugs of abuse. Opioid addiction is characterized by a powerful, compulsive urge to use opioid drugs, even when they are no longer required medically. Opioids have a high potential for causing addiction in some people, even when the medications are prescribed appropriately and taken as directed. Many prescription opioids are misused or diverted to others. Individuals who become addicted may prioritize getting and using these drugs over other activities in their lives, often negatively impacting their professional and personal relationships. It is unknown why some people are more likely to become addicted than others. Opioids change the chemistry of the brain and lead to drug tolerance, which means that over time the dose needs to be increased to achieve the same effect. Taking opioids over a long period of time produces dependence, such that when people stop taking the drug, they have physical and psychological symptoms of withdrawal (such as muscle cramping, diarrhea, and anxiety). Dependence is not the same thing as addiction; although everyone who takes opioids for an extended period will become dependent, only a small percentage also experience the compulsive, continuing need for the drug that characterizes addiction. Opioid addiction can cause life-threatening health problems, including the risk of overdose. An overdose occurs when high doses of opioids cause breathing to slow or stop, leading to unconsciousness and death if the overdose is not treated immediately. Both legal and illegal opioids carry a risk of overdose if a person takes too much of the drug, or if opioids are combined with other drugs (particularly tranquilizers called benzodiazepines).

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