What Are the Risks
Associated with Opioids?
Anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggle with opioid addiction. Once addicted, it can be hard to stop. In 2014, nearly two million Americans either used more than prescribed or were dependent on prescription opioid pain relievers.
Taking too many prescription opioids can stop a person’s breathing—leading to death. Prescription opioid overdose deaths also often involve alcohol and benzodiazepines (central nervous system depressants used to sedate, induce sleep, prevent seizures and relieve anxiety). Examples of benzodiazepines include alprazolam (Xanax®), diazepam (Valium®) and lorazepam (Ativan®). Taking benzodiazepines or consuming alcohol while taking prescription opioids greatly elevates the risk of an overdose. Avoid taking benzodiazepines while taking prescription opioids whenever possible.
Risk factors for prescription opioid pain reliever abuse and overdose include:
- Obtaining overlapping prescriptions from multiple providers and pharmacies.
- Taking high daily dosages of prescription opioid pain relievers.
- Having mental illness or a history of alcohol or other substance abuse.
Are There Alternatives
Opioids are commonly prescribed for acute pain, such as pain from an injury or surgery. They are not your only option for reducing pain. Over the counter relievers (ibuprofen, naproxen and acetaminophen), as well as physical therapies/treatments (application of heat/ice, massage, acupuncture, etc.) can help you manage your pain–often as well as or better than opioids–without the risks associated with opioids. Talk to your doctor about using over the counter pain relievers for extended periods of time.
Read the Centers for Disease Control and Prevention’s guide, “Opioids for Acute Pain,” to understand your risks, what to expect from your doctor and your responsibilities if you are prescribed an opioid medication.
Should I Ask My Healthcare Provider?
To understand the risks of prescription opioid misuse and the best ways to secure, take and dispose of your medicines, talk to your healthcare provider before getting a new prescription. Here are good questions to ask:
- Why do I need this medication?
- Is this an opioid?
- What are the risks?
- Are there non-opioid alternatives that could help me recover?
- Is this medication safe to take with my other medications?
- Is this the lowest dose possible? May I have fewer pills?
- How can I reduce the risk of potential side effects from this medication?
- How should I taper off the medication?
- How should I store my medication to prevent misuse?
- What should I do with unused and/or expired medicine?
- What if I and/or my family have a history of addiction with tobacco, alcohol or other substances?
- Can I have a prescription for naloxone (Narcan) to keep on hand?
Learn more from the U.S. Food and Drug Administration.
What If My Child
Is Prescribed an Opioid?
If a doctor suggests an opioid prescription for your child, it’s important you know the right questions to ask. And if your child is prescribed an opioid, be sure he or she takes the medication as intended and doesn’t share it with others.
How are Healthcare Providers Helping You?
Many healthcare providers are working to proactively identify and educate patients who may be at risk of substance misuse or addiction, and ensure they receive the best possible care.
With support from the Centers for Disease Control and Prevention, Atrium Health (formerly known as Carolinas HealthCare System) developed an innovative alert system that warns healthcare providers to reconsider writing an opioid prescription for a patient at risk of misuse or addiction. The electronic alert lets a prescriber know when a patient is already taking opioids, has had an opioid or drug-related overdose, or has has struggled with substance misuse or addiction in the past. This information helps prescribers decide whether an alternative course of treatment or overriding the alert and prescribing an opioid is a better treatment plan for the patient. Learn more from Atrium Health, or this article on the new technology.
Many providers also use a strategy to help discuss previous or current alcohol and drug use with patients as part of routine medical visits. The Screening, Brief Intervention, and Referral to Treatment strategy, or SBIRT, has three steps:
- Screening for risky alcohol or drug use consists of a few questions that help identify patients who may be misusing alcohol or drugs, as well as patients at high risk of alcohol or drug misuse.
- Brief Intervention is a conversation between the provider and the patient where the provider explains the concerns about misuse that arose from the initial screening, and the patient has an opportunity to respond.
- Referral to Treatment is offered to patients who wish to receive further assessment, treatment, or services related to alcohol or drug misuse.
See video demonstrations and learn more about SBIRT from the Governor’s Institute.
Healthcare providers who want more information about these and other strategies for addressing the opioid epidemic should consult our Healthcare Provider Resources.