FAQs

When explaining pain to a doctor during an initial visit, be as specific as possible around the location of the pain, characteristics (eg, shooting, sharp), how often you feel it, and the severity.1 Try to recall as many details as you can from the last day to last week when the pain was present, what activities you were doing, if the pain prevents any activities, if anything relieves the pain, and how you cope with the pain.1 If you keep a pain diary of signs and symptoms, or have other related information, it would be beneficial for the doctor to have this additional knowledge.2

The doctor might give you scales and questionnaires to help you describe the pain, and its best to answer them as honestly as possible, even if you think you might be exaggerating or minimizing the pain.3

Keeping track of the pain’s severity on a daily basis after the initial visit is helpful in tracking the effectiveness of any treatments the doctor recommends, and can be shared during follow-up visits.2

Not all pain requires an opioid, and it is usually not the first-line of treatment. Your doctor might recommend non-pharmaceutical therapies or non-opioid medications such as NSAIDs, acetaminophen, or others.4 If your doctor thinks an opioid prescription is needed, there might be an option to start on a trial dose, especially if you have never taken an opioid before.5 However, any treatment should start only after discussing treatment risks, benefits, and your medical history with your doctor in order to decide the most effective treatment option.5

Anyone who takes prescription opioids has a chance of becoming addicted.6 Some people are at a higher risk of developing addiction, depending on any past or current substance use disorder (SUD), family history of mental illness or SUD, genetics, comorbid conditions, such as PTSD, other medication use, and several other factors.6 It is best to share all of your concerns with the doctor prior to starting opioid therapy. Your doctor will start the opioid treatment at the lowest dose possible for the shortest amount of time.7

Physical dependence on opioids is based on developing tolerance to opioid therapy over time, and experiencing withdrawal after stopping the medication.8 Physical dependence is a normal response to use of opioids, especially after prolonged use. Addiction is not the same thing as physical dependence. Addiction involves a physical dependence as well as a compulsive use, craving, and impaired control in drug taking.8

Misuse of a drug is defined as taking a drug in a way other than the way it was prescribed.9 For example, misuse can be a one-time event due to a misunderstanding of instructions. Abusing a drug can mean taking a drug without a prescription, intentionally taking more than the required dose, or taking it to achieve a certain sensation or feeling.9

Signs of addiction to opioids include strong cravings and urges to take opioids even when not in pain, mood swings, poor decision-making, seeking opioid prescriptions from multiple providers, borrowing medications from others, changes in patterns at work, home, or school, changes in physical appearance, and other social and behavioral shifts.10 It can be difficult to seek help for an opioid use disorder, but there are many services and treatments available. The first step can be to talk to a family member or loved one about your concerns.

It’s important never to suddenly discontinue an opioid treatment. Your doctor will provide methods to safely discontinue the treatment, and can also prescribe medications to treat symptoms of withdrawal.

The most common side effects of opioids are constipation and nausea. Less common side effects include drowsiness, dizziness, respiratory depression, vomiting, and muscle rigidity.11 It’s important to speak to your doctor prior to opioid therapy about these side effects and if you may be more susceptible to them, for example if you have existing gastrointestinal or respiratory disorders.11

Side effects of opioids can be managed by your doctor by lowering the dose, rotating to a different opioid, or changing the way you take the opioid (route of administration).12 Your doctor might also recommend or prescribe medication for nausea, and/or a stool softener with a stimulant laxative for constipation.12

Side effects such as slowed breathing or heart rate might indicate an opioid overdose, and emergency services should be contacted.13 If available, naloxone, a medication that reverses opioid overdose, should be administered immediately.6

You should never take another person’s pain medication, whether it is from a family member or anyone else. You should also never share your pain medication with anyone else. Giving away your opioids can be illegal, and using another person’s medication can lead to overdose or addiction.14,15

Certain non-opioid pain medications can interact with other medications and alcohol, and it is best to consult your doctor prior to initial use.

Opioid prescriptions should never be taken with benzodiazepines (prescription sedatives like diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin)), alcohol, xylazine, or any other sedative. Taking any of these substances with opioids can greatly increase the chance of a fatal or life-threatening overdose.16

A doctor will not prescribe an opioid if there is a risk of opioid misuse or addiction.17 This can be due to a past or current SUD, or a mental health illness. There can also be other medical risk factors such as another medical condition or concurrent prescription that prevents opioid use.17 The health care professional might also be limited by certain state laws or guidelines around opioid prescribing for your type of pain (eg, your dentist may not be licensed to prescribe opioids).18 Health care professionals have access to a prescription database called PDMP, and are able to see past or current prescriptions.19 This also helps them decide whether or not they are able to prescribe you an opioid.

Opioid use should never be prolonged, and if there is long-term opioid use, your doctor may speak with you about tapering the medication.17 It is important that you don’t abruptly stop the opioids as this can cause severe withdrawal effects.17

References

  1. National Institute of Neurological Disorders and Stroke. Pain. Last updated July 22, 2024. https://www.ninds.nih.gov/health-information/disorders/pain
  2. Kaiser Permanente. Learning About a Pain Diary. Last updated July 10, 2023. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.learning-about-a-pain-diary.abk1346
  3. Dydyk AM, Grandhe S. Pain Assessment. StatPearls. Last updated January 29, 2023. https://www.ncbi.nlm.nih.gov/books/NBK556098/
  4. Stanford Medicine. Management of Pain without Medications. https://stanfordhealthcare.org/medical-conditions/pain/pain/treatments/non-pharmacological-pain-management.html
  5. Rhode Island Department of Health. Safe Opioid Prescribing. https://health.ri.gov/healthcare/medicine/about/safeopioidprescribing/
  6. Curb the Crisis. Recognizing and Responding to an Opioid Overdose. https://curbthecrisis.com
  7. Dowell D, et al. CDC Guideline for Prescribing Opioids for Chronic Pain–United States, 2016. JAMA. 2016;315:1624-1645.
  8. Horowitz MA, Taylor D. Addiction and physical dependence are not the same thing. Lancet Psychiatry. 2023;10:e23. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00230-4/fulltext
  9. American Academy of Family Physicians (AAFP). Chronic Pain Management and Opioid Misuse: A Public Health Concern (Position Paper). https://www.aafp.org/about/policies/all/chronic-pain-management-opiod-misuse.html
  10. Mayo Clinic. How to tell if a loved one is abusing opioids. January 19, 2024. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-tell-if-a-loved-one-is-abusing-opioids/art-20386038
  11. Benyamin R, et al. Opioid complications and side effects. Pain Physician. 2008;11(2 suppl):S105-S120.
  12. Swegle JM, Logemann C. Management of common opioid-induced adverse effects. Am Fam Physician. 2006;74:1347-1354.
  13. Cleveland Clinic. Opioid Overdose. January 4, 2023. https://my.clevelandclinic.org/health/diseases/24583-opioid-overdose
  14. Mayo Clinic. Prescription drug abuse – Symptoms and causes. October 25, 2022. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813
  15. VA National Pain Management Program. Taking Opioids Responsibly. October 17, 2012. https://www.va.gov/painmanagement/docs/takingopioidsresponsibly20121017.pdf
  16. National Institute on Drug Abuse (NIDA). Benzodiazepines and Opioids. November 7, 2022. https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids
  17. US Department of Health and Human Services. HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. October 2019. https://www.cms.gov/about-cms/story-page/cdcs-tapering-guidance.pdf
  18. Le TT, et al. Respiratory events associated with concomitant opioid and sedative use among Medicare beneficiaries with chronic obstructive pulmonary disease. BMJ Open Respir Res. 2020;7:e000483
  19. Dowell D, et al. CDC Clinical Practice Guideline for Prescribing Opioids for Pain United States, 2022. MMWR Recomm Rep. 2022;71:1-95.

All URLs accessed August 23, 2024.

Pin It on Pinterest

Scroll to Top

For optimized Clinical Trial Tracker use, please utilize Chrome or Firefox browsers