Painkiller facts

a picture of pain medications

Opioid medications, also known as pain medications, are useful for controlling pain but carry potentially serious risks. To find out more, we met with Humana Pharmacy® pharmacist Melanie Sadler for a question-and-answer session.

Melanie Sadler, Pharm.D., board certified pharmacotherapy specialist (BCPS), is a clinical advisor pharmacist for Humana At HomeSM. She has been in this role for over 3 years. Before joining Humana At Home, she spent 7 years as a clinical pharmacist for the RxMentor® department. Sadler graduated from University of Missouri-Kansas City School of Pharmacy, completed a residency in family medicine pharmacotherapy at Idaho State University, participated in several published research projects and served as a co-director for a cardiology residency program before joining Humana. 

Q: What is an opioid?

A: Opioids are certainly a hot topic in the news. It is important for our members to understand more about them. Opioids are natural or synthetic medications derived from the opium poppy. They interact with receptors in the body to relieve pain, suppress cough and produce other effects.

Q: Why are these medications usually prescribed?

A: Opioids are most commonly prescribed for acute pain, such as from surgery or an injury, or chronic pain, such as from back problems or cancer. However, as the opioid and substance abuse crisis continues, there is more use of opioids to treat opioid or illicit drug dependence. Opioids are also sometimes prescribed to treat cough or diarrhea.

Q: What are some commonly prescribed opioids?

A: Some of the most frequently prescribed opioids are hydrocodone (Vicodin, Lortab, Norco), oxycodone (OxyContin, Percocet), fentanyl (Duragesic), morphine (MS Contin, Avinza, Kadian), codeine (Tylenol #3, Cheratussin) and meperidine (Demerol). 

Q: I’ve heard there are risks when taking opioids. Is this true?

A: Yes, this is true. Taking opioids may lead to addiction. Patients should follow their doctor’s instructions carefully and take their medication exactly as prescribed to prevent the risk of dangerous side effects. Side effects may include, but aren’t limited to, drowsiness, dizziness, inability to think clearly or react quickly, respiratory depression, nausea, vomiting and constipation. Taking other medications can enhance these effects. 

Q: My provider told me they can only prescribe a limited supply of an opioid pain medication due to a change in my state’s laws. Is this true?

A: This is likely true. Many states have passed new laws limiting the amount of opioid pain medications that can be prescribed for acute pain episodes and after surgery. Some states have even limited the amount of opioids that can be prescribed by different professions, such as dentists versus doctors. There are also several states placing regulations on opioid prescriptions for chronic pain. For changes in your state, you should check with your provider, local pharmacist and individual state’s rules or laws. 

Q: How can I safely store my medicine?

A: Opioids should be stored in a cool, dry area where children can’t get to them. Because opioids are controlled substances and highly sought after, patients should keep these in a locked container or safe.

Q: What should I do if I have leftover medicine?

A: There are local and national medicine take-back programs to safely dispose of medications.There are also some retailers dispensing or selling products to dispose of or destroy medications. If these aren’t available, medications can be mixed with an unpleasant substance such as used coffee grounds, cat litter, or dirt in something closeable, such as a re-sealable bag, can, or container, and placed in the household trash. Any opioid medication, other than fentanyl patches, should not be flushed down the toilet or a drain.

Q: What are some alternatives if I want to avoid opioids?

A: You can ask your doctor if any of the following alternatives to opioids are appropriate for you: acetaminophen (Tylenol), non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), select antidepressants such as duloxetine (Cymbalta) or nortriptyline (Pamelor), select anticonvulsants such as gabapentin (Neurontin) or pregabalin (Lyrica), medications that can be applied to the skin, medications that can be injected into targeted areas, physical therapy and/or behavioral therapy. There is data that shows when patients take ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) together, they experience pain relief as good as or better than some opioids1.

Q: How can I tell if I may be addicted to my opioid medication, and what should I do if I think I’m becoming addicted to my medicine?

A: Each time you take your opioid medication, you should ask yourself, “Why am I taking this medication?” Then ask the following questions:

  • Are you taking the medication because you are in pain? 
  • Are you taking it because you’re having withdrawal symptoms, including nausea, muscle cramping, diarrhea, agitation, anxiety, sweating, runny nose, watering eyes, tremors or insomnia? 
  • Are you taking it because you get a high or just like the way you feel when you take it?

If you’re not taking your opioid medication for a legitimate reason or think you are addicted or dependent on your opioid medication, you should seek medical attention immediately. Abuse of opioids can have serious harmful effects, including death.

This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional. You should consult with your doctor to determine what is right for you.

Additional Resources:

CDC Links for Documents:

Guideline for Prescribing Opioids for Chronic Pain

Pocket Guide: Tapering Opioids for Chronic Pain

Nonopioid Treatments for Chronic Pain

Assessing Benefits and Harms of Opioid Therapy

Why Guidelines for Primary Care Providers? 

Pharmacist’s Letter Links for Documents:

Appropriate Opioid Use

Be Ready to Handle Restristions on Initial Opioid Prescriptions 

Source:

1. “Alternative Treatments Fact Sheet.” www.cdc.gov. April 27, 2016. Accessed June 25, 2018. https://www.cdc.gov/drugoverdose/pdf/nonopioid_treatments-a.pdf.

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