Pain Medication: What are Opioids?
Opioids are a type of pain medication made from the poppy plant. It is the same plant that is used to make opium and heroin. They are effective for treating acute or new pain after an injury or surgery. Opioids are less effective for treating chronic pain, headaches, or nerve pain. They can also be used to treat cancer pain at the end of life. Commonly used opioid pills include hydrocodone, oxycodone, hydromorphone, tramadol and codeine.
Misuse of Opioids: A large and growing problem
Over the last 15 years, the prescription of opioids has increased tenfold. Misuse now kills more than 100 people each day in the United States. Opioids kill more people than both suicide and motor vehicle collisions combined. Nearly 16,000 Americans died of overdoses involving these pain relievers in 2009. Most of these deaths were accidental.
The pain problem
It is common for pain to occur after injury or surgery. Pain relievers like opioids don't take away pain all the way. They just make the pain less bothersome. Patients can develop tolerance to opioids and sometimes get addicted. A higher tolerance means it requires more medicine to get the same amount of pain relief. When more medicine is used, the risk of side effects goes up. This is why opioids work well in the short-term but can be harmful for long-term pain relief.
Recreational use
Opioids can be, but should not be, used to get high. Over half of teens abusing these medicines get them from family or friends without their knowledge. In addition to potential poisoning, recreational use of opioids creates addiction. One study of heroin users found that 39% of addicts reported being “hooked” on prescription pain relievers first. Opioids and other pain relievers should be kept in safe and secure locations to prevent their misuse.
Signs and Symptoms
The most common side effects of opioids are nausea, constipation, itching, and drowsiness. The most serious effect is a decrease in breathing, which can result in death. The chance of death can increase when opioids are used with alcohol or other drugs that make you sleepy.
Treatment
The progress of your treatment and your opioids medication use should be discussed with your providers often. While they want to limit your pain after surgery or injury, they also understand the risks of abuse, addiction and death with these medicines. To reduce these risks, your provider may switch to over-the-counter medicines such as ibuprofen or acetaminophen once the initial intense pain subsides. In most cases you will need to stop using opioid pain medication before the pain is totally gone. A safe period of time to use opioids is often 3 days or less.
Disposal
Opioids should be disposed of when they are no longer needed to treat your injury or surgery. Studies report that 10% to 30% of pain relievers are never used. Leftover opioids kept at home increase the risk of accidental poisoning and drug abuse. These tragedies often affect family members or friends.
Some law enforcement agencies, pharmacies, and hospitals have drop boxes or have designated dates to collect pain medicines like opioids. Do not flush the pills down the toilet. Water treatment facilities do not effectively remove these drugs, so pollution of drinking water is a growing concern.
© 2020 American Society for Surgery of the Hand
This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand. Find a hand surgeon near you.