Some people worry about the safety of opioid pain medicines and how to balance safety with pain control. Opioids are usually very safe when taken as prescribed. Even still, opioids are powerful medications and can have some serious safety problems when not handled properly. Here you will learn how to keep yourself safe when taking opioids, and the people around you.
Safety concerns with opioids
Opioids can sometimes make a person feel sleepy. Some people notice that it can slow their thinking, and it can make them unsteady on their feet. When a person has these side effects, they can be at risk for hurting themselves (or someone else) by falling or having another sort of accident. Aside from the risk of falls and injuries, the most serious safety concern with opioids is overdose. Opioid overdose almost never happens if a person is taking their opioid medications correctly.
Understanding opioid overdose
Stories about opioid overdoses are in the news almost daily, which can be scary if you need them to control your cancer pain. Overdose happens when a person takes a high dose of an opioid that their body isn’t used to. Overdose almost always happens when someone is abusing prescription opioids or buying opioids off the street.
Thankfully - opioid overdose is extremely rare if someone takes their pain medications as prescribed.
What opioid overdose looks like
When a person overdoses on opioids they lose consciousness (pass out) and their breathing becomes dangerously slow or stops. This is different from falling asleep after taking an opioid (breathing normally and easily awoken), which is very common and does NOT mean that a person has overdosed.
Although it is extremely rare, a few things might increase a person’s risk for opioid overdose:
When taking opioids, stay away from drinking alcohol. This can make the sedating effects of opioids worse. Over the course of your treatment, you may also be prescribed other medications that can sometimes cause drowsiness. Try to take these medications at a different time than your short-acting opioids. Tap to see a full list of other medicines that can make you drowsy.
If you are on a very high dose of opioid pain medications or have other risk factors for opioid overdose (see above), talk to your doctor about having Narcan (Naloxone) at home. In the rare case of an opioid overdose, Narcan (Naloxone) reverses the effects of the opioid and could save your life. Make sure that the people who spend the most time with you know how to give Narcan (Naloxone), and when to give it. In many states you can get Naloxone from the pharmacy without a prescription. The pharmacist can teach you how to use it.
Many states have laws saying you cannot drive while taking opioids. The reason is that opioids can slow your thinking and your ability to react to changes on the road. We understand this can be incredibly difficult, isolating, and life-changing. Although hard, there are ways to adapt. It is most important to tell your friends and family that you need help with transportation and be okay accepting their help. Here are some other resources you can use.
Public Transportation: Many cities, including Boston, have public transportation systems with trains and buses. These systems usually have extra services for people with health problems like cancer. Here are examples of extra support within Boston’s public transit system, the MBTA.
The RIDE is a door-to-door, shared-ride service. Apply here.
Boston Age Strong Shuttle provides shuttles to non-emergency medical appointments for qualifying persons (call 617-635-3000)
Bus Buddies: A trained volunteer Bus Buddies is available to help you navigate the MBTA, public transportation in Boston. Call 617-635-4366 for more information
Taxi Coupons: The city of Boston sells taxi coupons at a 50 percent discount to Boston residents age 65 and older at the office in Boston City Hall. You can call Boston City Hall at (617) 635-4500.
Ride Sharing Apps: There are several ride sharing apps including Lyft and Uber that can help you maintain independence. Most platforms have a ride sharing option, which is usually less expensive.
It’s important to keep track of your medicine, including how many you take each day and how many pills you have left. It can be easy to lose track and accidentally take too much in a day. This can help you know when to ask for a refill too. If you’re running out, call you care team and request a refill for a medicine, as this can take up to 5 days.
Use this app to keep track of how you feel when taking opioids. If you have a side effect that worries you, call your care team as soon as possible. Tap to learn more about opioid side effects.
Important safety tips when taking opioids:
This is a rule your doctor follows to keep you safe. Doctors prescribe a low dose of opioids to start. If needed, they slowly increase the dose until you find what works best for you. In the same way, the first time you take an opioid (or if your prescription is changed), you should always try the lowest dose first. For example: if your prescription says: “take 1 or 2 tablets as needed for pain,” start with one tablet. If you tolerate it, the next time you need pain medicine it is okay to try the higher dose.
If possible, it is best to have company the first time you take a new opioid medication, just in case you have a side effect you didn’t expect. Also, it’s best to take the opioid medication at least a few hours apart from any other medication that might cause drowsiness.
Over time, our bodies can get used to opioids, and we may need more medicine to get relief. This is called tolerance. If this happens, don’t increase your medication on your own. Work with your care team to find the dose that works for you and stick to that dose.
Also, if you find that your pain gets a lot better, don’t stop taking your opioids without talking to your care team. Stopping your opioids suddenly can cause you to go into withdrawal. Symptoms of withdrawal include diarrhea, vomiting, pain, and flu-like symptoms. Talk to your care team to create a safe plan if you are interested in lowering your opioid dose or trying to get off of it.
The bottle labels can be confusing. Make sure to ask your doctor, nurse, or pharmacist if you have questions about the instructions.
Although weekly pill organizers can be very helpful for some medications, you should keep your opioids in their original bottle. It is easy to get pills mixed up with each other and accidentally take the wrong amount.
This makes your body absorb the medicine more quickly, which can be dangerous. Talk to your care team if you are having trouble swallowing your pills.
A good rule of thumb is if you are no more than 2-3 hours late taking your long-acting opioid, go ahead and take it as soon as you realize that you have missed the dose. If you are later than this, talk to your care team about what to do. They might have you take your missed dose, and they may also instruct you to reschedule your next scheduled dose.
Other safety tips:
Tips to keep the people around you safe:
Only tell the people directly involved with your care that you are using opioids to manage your pain.
Don’t leave opioid medication bottles out on the table, kitchen and bathroom counters, or on your bedside table. Keep them in a place where they are safe, and they cannot be accidentally (or purposely) taken by someone else. Ideas include a medicine cabinet or bedside drawer.
If you have small children in your house, or if anyone with an addiction problem has access to your home, the safest place to keep your medication is a lock box.
If you stopped taking one of your pain medications, try not to keep the pills around your house. Drop off them at your local pharmacy or your local police station, to be destroyed.
It is dangerous for anyone other than you to take your opioid pain medication. For this reason, keep your medications safe and secure so that no one (like a small child) could accidentally take them. Most people know someone who has struggled with opioid addiction or other forms of substance abuse. Keeping your medications safe and secure can also protect these people from the dangers of opioids. Here are some specific steps you can take:
If you are worried about someone you know, you can call 1-800-662-HELP (4357) at any time to find drug treatment centers near you.
Also, this website has good information if you would like to learn more about opioid safety, abuse and addiction: https://easyread.drugabuse.gov/
