Avoid Opioids for Most Long-Term Pain

Advice from experts

Opioids have been in the news a lot lately. To help you make sense of them, we’ve gathered advice from the Centers for Disease Control and Prevention, doctors’ groups, and Consumer Reports Best Buy Drugs. In this guide you can read what the experts say about using opioids.

 

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Choosing Wisely
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Opioids are very strong prescription pain drugs.

They include Oxycontin, Vicodin, and Percocet.

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Opioids Can Be Deadly

During the past 15 years, there has been a huge jump in the amount of opioids prescribed for chronic pain. And, that is risky because more than 14,000 Americans died of overdoses from opioids in 2014. And each day, more than 1,000 people are treated in emergency rooms from opioid misuse.

Source: Centers for Disease Control and Prevention

Opioids can cause bad side effects. (See “Some Side Effects of Opioids.”) But might be OK to use them for severe pain that lasts for a short time. This includes pain from surgery or a broken bone.

You can also use opioids for long-term (chronic) pain caused by cancer and other serious health problems. But they should be the last resort for other types of chronic pain. Here’s why:

Opioids can make some types of chronic pain worse. For instance, they can make migraines worse and more frequent. And they can make pain in your lower back last longer.

Over time, your body gets used to the effect of opioids. In order to get relief, you may need to take higher and higher doses. As a result, you may get addicted to opioids. You could also overdose. And an overdose can kill you. (See “Opioids Can Be Deadly.”)

So before you use opioids to treat chronic pain, try safer and better methods first. (See “Other Treatments for Chronic Pain.”) If you do use opioids for chronic pain, follow the guidelines for using them safely. (See “How to Use Opioids Safely.”)

 

Some Side Effects of Opioids

If you take opioids, you may feel:

  • Anxious
  • Confused 
  • Depressed 
  • Dizzy
  • Itchy
  • Sick to your stomach, or even throw up 
  • Sleepy

If you take opioids, you may have:

  • Hot flashes
  • Irregular periods 
  • Less interest in sex
  • Slow breathing that can lead to death
  • Weakened immune system 
  • Worse pain

If you take opioids, you may have trouble:

  • Getting an erection
  • Having an orgasm
  • Moving your bowels
  • Remembering things

Tell your doctor about any side effects you have.

Other Treatments for Chronic Pain

Before you use opioids to treat chronic pain, try safer and better methods first. These include drugs and non-drug treatments. Ask your doctor which options are right for you. Here are treatments for some common causes of chronic pain.

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Lower-back pain

Non-drug options

Stay active: walk, swim, bike, or do yoga. Try chiropractic care, physical therapy, acupuncture, or massage. Some people find cognitive behavioral therapy helpful. In most cases, lower-back pain goes away in about a month—even without treatment. If not, see your doctor.

Drugs

Try acetaminophen, ibuprofen, or naproxen.

 

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Migraine

Non-drug options

To prevent a migraine, avoid things that trigger your headache. These may include alcohol and certain foods. Control stress: stay active, meditate, and breathe slowly and deeply. And make sure you get enough sleep.

Drugs

If you get mild to moderate migraines, first try acetaminophen, ibuprofen, or naproxen. Or try a mixture of aspirin, acetaminophen, and caffeine as found in Excedrin Migraine and generic versions. If you get severe headaches, or get many in a month’s time ask your doctor about prescription drugs.

 

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Joint pain

Non-drug options

Losing weight and staying active can reduce joint pain. They may even keep your arthritis from getting worse. Try a heating pad for stiffness and ice for swelling. A cane, walker, or over-the-counter knee brace can ease pain.

Drugs

Ibuprofen and naproxen work best. Acetaminophen may also help. Ask your doctor about prescription pain relievers that come in a skin cream form.

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Nerve pain

Non-drug options

Try physical and occupational therapy. If you have nerve pain from diabetes, be sure to keep your blood sugar in a healthy range.

Drugs

You could try medication that is also used to treat seizure and depression. These can help with nerve pain, too. Also ask about a skin patch with lidocaine.

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Fibromyalgia

Non-drug options

Stay active, meditate, or do cognitive behavioral therapy. You can also try tai chi, which combines slow, gentle movements with deep breathing.

Drugs

If those don’t work, consider medication, which is sometimes used for seizures and depression.

How to Use Opioids Safely

Opioids can cause bad side effects. Over time, they can cause addiction—or even death. If you take opioids, follow these safety tips:

 

  • Talk with your doctor. Before you start using opioids, talk with your doctor. Discuss how these drugs could help—or harm—you. Tell your doctor if you or a family member has ever had a problem with drugs or alcohol.
  • Limit your dose. Have your doctor prescribe the lowest dose of opioids that treats your pain.
  • Limit treatment for short-term pain. Three to seven days of treatment is likely enough. For pain from surgery or a severe injury, you may need longer treatment.
  • Take opioids the right way. Take the right amount at the right times. Stop taking opioids if they don’t ease your pain and make it easier to do daily tasks.
  • Don’t mix opioids with other drugs. Don’t take opioids with alcohol, illegal drugs, or other medicines unless your doctor says it’s OK. Some mixtures can be deadly.
  • Don’t drive when you first start an opioid. It can be dangerous. Also don’t drive if you dose has increased until you know how it affects you.
  • Store opioids safely. Keep them in a locked drawer or cabinet. This keeps other people from using them. Never share your supply with another person.
  • Use your own pain medication. Never use another person’s prescription opioid.
  • See your doctor often for long-term pain. Your doctor will look for signs taking too much of the drug or getting addicted. Tell your doctor about any side effects you have.

Avoid Opioids While You Are Pregnant

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Opioids can harm your unborn baby:

  • If you take them early in pregnancy, your baby may be more likely to have brain, spine, heart, or belly problems.
  • If you take them late in pregnancy or for more time, your baby can be born addicted.

Addicted babies may have seizures and low birth weight. They may also have trouble breathing and eating. As a result, they may need to stay in a special unit at the hospital after they are born.

So if you are—or could be—pregnant, avoid taking opioids. Ask your doctor about safer ways to ease your pain:

  • If you need an opioid for severe pain, limit treatment. Try to take it for three days or less.
  • If you take an opioid for chronic pain, talk to your doctor. Discuss the best way to stop taking it. Stopping the drug on your own could harm your baby.
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This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2016 Consumer Reports.