If you have severe pain, you may be prescribed an opioid medication. This can happen such as if you have been in a car accident, or if you have chronic pain. Though opioids are good at relieving pain, there are many possible dangerous side-effects, as well as many people who become addicted to these medications or overdose.
As someone with a chronic pain condition, I have used several opioid medications over the years, combined with muscle relaxers. The problem with using these medications for a long period of time is that you can become dependent on them and have many dangerous side effects.
For example, I have taken both Percocet and Tramadol, both of which are opioid medications.
Side effects of Percocet, according to Green Hill Recovery:
Life-threatening respiratory depression
Hypotension and syncope
Side effects of Tramadol, according to Health Direct:
All opioids, including tramadol, can have side effects that include life-threatening breathing problems. The risk of these is higher:
when you first take tramadol
after a dosage increase
if you are older
if you have an existing lung problem
The side effects of tramadol are similar to those of other opioids, and include:
headache or dizziness
fatigue or drowsiness (especially right after a dose)
loss of appetite, nausea and vomiting
These are just a couple of examples of side effects of opioid medications that you may have been prescribed for your pain condition. You can read additional facts in the booklet that comes with your medication or ask your doctor of a pharmacist for a fact-sheet.
Some additional opioid medications, according to the Kansas Pharmacy Board, include:
Vicodin, Norco and Lortab (Hydrocodone with Acetaminophen)
Percocet (Oxycodone with Acetaminophen)
If you have been prescribed an opioid medication and are concerned about possible side effects or addiction, you can ask your doctor for a non-opioid medication instead. However, if you do decide to take the medication, be sure to use as directed by your doctor. These medications are best for short-term use only, as they can have many dangerous side effects if used for too long.
The Opioid Crisis
There is currently an ongoing opioid crisis in the United States. This is partly due to use of these medications that goes against medical advice, including recreational use. It can also be caused due to becoming addicted when you are prescribed these drugs for a medical purpose.
Overdose is a big problem with opioids. This can include prescription medications as described above, as well as heroine and fentanyl. Many times, you will hear about teens overdosing on fentanyl.
According to the CDC,
From 1999-2021, nearly 645,000 people died from an overdose involving any opioid, including prescription and illicit opioids
During this time period, they have observed three different waves of the opioid crisis, which started with doctors over-prescribing these drugs to patients. If you have chronic pain, you may have noticed that it has gotten harder to obtain a prescription for pain-killers, and this is the reason.
The CDC explains the 3 waves of the opioid crisis like this:
The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.
The second wave began in 2010, with rapid increases in overdose deaths involving heroin.
The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl. The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine.
In the 90's when these drugs were first being prescribed in large numbers, doctors were most likely just thinking about the immediate needs of the patient and their care, instead of thinking about long-term consequences of prescribing these drugs.
According to the WHO, here are some risk factors for opioid overdose:
having an opioid use disorder;
taking opioids by injection;
resumption of opioid use after an extended period of abstinence (e.g. following detoxification, release from incarceration, cessation of treatment);
using prescription opioids without medical supervision;
high prescribed dosage of opioids (more than 100 mg of morphine or equivalent daily).
using opioids in combination with alcohol and/or other substances or medicines that suppress respiratory function such as benzodiazepines, barbiturates, anesthetics or some pain medications; and
having concurrent medical conditions such as HIV, liver or lung diseases or mental health conditions.
When you use an opioid medication as prescribed by a doctor, there is less risk involved than when you buy it on the street. Many drug dealers are selling fentanyl products illegally, which contributes to the opioid epidemic. The illegal versions of these drugs limit a user's ability to know what the 'correct' dosage of the drug may be, and can lead to overdose.
People who are addicted to opioid medications and unable to get a prescription often turn to drug dealers and can receive an opioid that is either not in a pure form or more dangerous than what they would receive from a doctor.
Getting help for opioid addiction
There is help available for addictions to opioids. It is important to get help in recovery, if you or someone you know is suffering from an opioid addiction. It is important to speak to a professional when you stop use, because there are extreme withdrawal symptoms that can occur.
You can find help by talking to a medical provider, or by going to the emergency room, if you feel that you or someone you know is in immediate danger of an overdose.
To find long-term care for opioid addiction, the US Department of Health And Human Services has resources available online to find a treatment center near you:
If you suspect that someone you know is suffering from an opioid addiction, it is important to be kind when you speak to them, as this is a very difficult and serious problem to face. You can let them know that they are not alone, and you care about what they are going through. You can also help take them to a treatment center, and provide additional resources for them.
According to The Mayo Clinic, some risk factors for an opioid addiction may include:
Is a younger age, specifically the teens or early 20s
Is living in stressful circumstances, including being unemployed or living below the poverty line
Has a personal or family history of substance abuse
Has a history of problems with work, family and friends
Has had legal problems in the past, including DUIs
Is in regular contact with high-risk people or high-risk environments where there's drug use
Has struggled with severe depression or anxiety
Tends to engage in risk-taking or thrill-seeking behavior
Uses tobacco heavily
If you observe a change in someone's behavior, there is a risk that they could be abusing opioids. This may be the case if you know they were prescribed an opioid for a pain condition, or if you think they may be engaging in recreational use.
Some warning signs that someone may be abusing opioids, according to the Mayo Clinic are:
Regularly taking an opioid in a way not intended by the doctor who prescribed it, including taking more than the prescribed dose or taking the drug for the way it makes a person feel
Taking opioids "just in case," even when not in pain
Mood changes, including excessive swings from elation to hostility
Changes in sleep patterns
Borrowing medication from other people or "losing" medications so that more prescriptions must be written
Seeking the same prescription from multiple doctors, in order to have a "backup" supply
Poor decision-making, including putting himself or herself and others in danger
You may also notice changes in their personality or other behaviors at work or in school, or in the ways that they engage with others on a daily basis. If you suspect something may be wrong, it is important to reach out to them. You can speak to the individual, or with their doctor if you think they are abusing a prescription.
Help end the opioid crisis
Although it is important to intervene at a personal level if you think a loved one may be experiencing an opioid addiction, there are things we can do on a national level as well to help address this crisis.
Some things that can be done on a policy level, according to Brookings, include:
limiting inappropriate use of prescription opioids;
reducing the flow of illicit opioids (like heroin);
helping people seek treatment for opioid misuse; and
deploying harm reduction tools that blunt the risks of death, illness, or injury.
Although opioid medications are a part of treating chronic pain, there are other ways to reduce chronic pain as well. It is important for doctors to help patients seek out additional treatment in addition to taking medications to ease their pain, as this can be very helpful in the long-term.
Personally, I have found both physical therapy and yoga to be helpful. These help you to strengthen your muscles, reduce the risk of [additional] injury, and make your stronger and more flexible. When you have a stronger and healthier body, it can reduce the pain that you feel on a daily basis, which will make you less dependent on medications that you are taking.
In addition to what can be done by doctors to help their patients seek out additional treatments for chronic pain conditions to limit reliance on opioids for pain, we can provide additional education to the public at large about this crisis.
To get involved and help educate the people in your life about the opioid crisis, you can visit the CDC for resources and social media postings that you can use to promote the campaign to end the opioid crisis.
If you share these resources online, others will know that you are someone safe and trusted that they can talk to if they are struggling with an addiction. Breaking the silence around addiction can help people to seek recovery and treatment for opioid addiction.
When you talk to someone who is struggling with an addiction, you can help them to find treatment services, and give them needed strength to give up their addiction.
The more we speak up about these issues, the more we can help someone who is suffering from an addiction to break free.