This article outlines the uses, misuses, risk factors, and best practices for mitigating the risks involved in the use of prescription opioids.
Living with chronic pain can be devastating, and effective pain management is important to getting your life back. It is essential that you and your doctor discuss treatment options, carefully considering all of the risks and benefits. Some medications, such as prescription opioids, can help relieve pain in the short term but also come with serious risks and potential complications—and should be prescribed and used carefully.
Prescription opioids can be used to help relieve moderate-to-severe pain and are often prescribed following a surgery or injury, or for certain health conditions. These medications can be an important part of treatment, but also come with serious risk. It is important to work with your healthcare provider to make sure you are getting the safest, most effective care possible. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness.
What Are the Risks and Side Effects Involved With Opioid Medications?
More than 191 million opioid prescriptions were dispensed to American patients in 2017—with wide variation across states. Prescription opioids carry serious risk of addiction and overdose, especially with prolonged use. An opioid overdose, often marked by slowed breathing, can cause sudden death. The use of prescription opioids can have a number of side effects as well, even when taken as directed.
There is a wide variation of opioid prescription rates across states. Health care providers in the highest prescribing state, Alabama, wrote almost three times as many of these prescriptions per person as those in the lowest prescribing state, Hawaii. Drug overdose deaths continue to increase in the United States.
One cannot avoid the side effects of prescription opioids. 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 2016, more than 200,000 people died from overdose related to prescription opioids in the United States. Up to 1 out of 4 people receiving long-term opioid therapy in a primary care setting struggles with opioid use disorder. From 1999 to 2016, more than 630,000 people have died from a drug overdose.
Around 66% of the more than 63,600 drug overdose deaths in 2016 involved an opioid. In 2016, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was 5 times higher than in 1999. On average, 115 Americans die every day from an opioid overdose.
Some common side-effects of prescription opioids include:
Tolerance: the need to take more of a medication for the same pain relief
Physical dependence: the experience of withdrawal symptoms upon stopping a medication
Increased sensitivity to Pain: the same medication that was prescribed to relieve pain, can in fact increase your sensitivity to it and lower your pain tolerance
Nausea, vomiting, and dry mouth: prescription opioids have been known to cause these side effects, making you not feel well on top of already not feeling well
Sleepiness and dizziness: prescription opioids can lead to side effects that can get in the way of normal functioning, such as severe drowsiness and the perception of imbalance.
Confusion: a side effect of prescription opioids leading to the loss of a sense of control
Depression: prescription opioids can increase feelings of depression
Low Levels of Testosterone: prescription opioids have led to lower levels of testosterone leading in a lower sex drive, energy, and strength
Itching and sweating: many who take prescription opioids experience side effects such as perspiration and itchiness.
Who is Most At Risk for Addiction and Abuse?
Inappropriate prescribing practices and opioid prescribing rates are substantially higher among Medicaid patients than among privately insured patients. 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. Tell your doctor about your medical history and if you or anyone in your family has a history of substance misuse or addiction to drugs or alcohol. And never take opioids in higher amounts or more often than prescribed.
Risks for Addiction Are Greater With:
A history of drug misuse, substance use disorder, or overdose
Mental health conditions such as anxiety and depression
Sleep apnea and other difficulties falling and staying asleep
When people reach the age of 65 years and older, the likelihood of dependency increases Pregnancy
It is very dangerous to combine opioids with other drugs, especially those that cause drowsiness. Risk of opioid overdose and death increases at higher dosages, and when taken for longer periods of time or more often than prescribed.
What to Avoid While Taking Prescription Opioids:
Avoid alcohol while taking prescription opioids.
Unless specifically advised by your health care provider, avoid Benzodiazepines, such as Xanax or Valium
Muscle relaxants, such as Soma or Flexeril
Hypnotics, such as Ambien or Lunesta
Other prescription opioids
Know the Options: Alternatives to Opioids
Talk to your doctor about ways to manage your pain that don’t involve prescription opioids. Some of these options may actually work better and have fewer risks and side effects. Be Informed: make sure you know the name of your medication, how much and how often to take it, and it’s potential risks and side effects.
Alternatives to Opioid Pain Medication May Include:
Pain reliever such as acetaminophen, ibuprofen, and naproxen
Some medications that are also used for depression or seizures work well for neurological pain
Physical therapy and exercise are ways to address the underlying imbalances leading to pain, and can relieve pressure that might be causing pain
Cognitive behavioral therapy, a psychological, goal-directed approach, helps patients learn how to modify physical, behavioral, and emotional triggers of pain and stress
Interventional therapies, like injections, are alternatives for people considering prescription opioids and are effective when it comes to targeting specific nerves causing pain
Try additional complementary medical therapies, like massage and acupuncture to relieve muscle pain
Various compounded forms of medication, such as topical creams, may deliver similar medication in a more targeted fashion, helping avoid many of the negative side effects of systemic opioid pain medication
Hemp Oil has shown promise in helping pain patients avoid opioid solutions, which we carry over-the-counter at the pharmacy
If you are prescribed opioids for pain, it’s important to be mindful:
Never take them in greater amounts or more often than prescribed
Follow up with your primary health care provider regularly
Work together to create a plan on how to manage your pain
Talk about ways to help manage your pain that don’t involve prescription opioids
Talk about any and all concerns and side effects you may be experiencing
Help prevent misuse and abuse
Never sell or share prescription opioids
Never use another person’s prescription opioids
Store prescription opioids in a secure place and out of reach of others (thi may include visitors, children, friends, and family)
Safely dispose of unused prescription opioids: Find your community drug take-back program or your pharmacy mail-back program
Visit cdc.gov/drugoverdose to learn about the risks of opioid abuse and overdose
If you believe you may be struggling with addiction, tell your health care provider and ask for guidance, or call SAMHSA;s National Helpline at 1-800-622-HELP
Signs of an Opioid Overdose:
You may have seen someone who looks like they may be under the influence of prescription opioids. Recognizing an opioid overdose can be difficult. Here are a few signs and symptoms to look out for:
Unconsciousness or unresponsiveness
Shallow breathing or no breathing
If you suspect someone is overdosing or in distress, it is important that you don’t leave the person alone and that you call 911 and seek immediate medical care for the individual.
Living with Chronic Pain
Living with chronic pain can be challenging. It is essential that you and your doctor discuss treatment options with all of the risks and benefits carefully considered. Some medications, such as prescription opioids, can help relieve pain in the short term but also come with serious risks and potential complications—and must be prescribed and used carefully. CDC’s Guideline for Prescribing Opioids for Chronic Pain helps increase providers’ ability to offer safer, more effective pain management. The Guideline and supporting resources support clinical decision making about prescribing opioids.
Remember, your doctor is a partner in your pain treatment plan. Talk to them about any other medications you are taking, especially those that cause drowsiness or slow your heart rate. It’s also important to talk about any and all side effects and concerns to make sure you’re getting the safest and most effective care.
Source for Article: CDC
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