Understanding Opioid Medicines for Pain Management

Opioids are medicines that can help ease pain. They're stronger than most over-the-counter pain relievers. They must be prescribed by a health care provider. They can be used to treat both acute and chronic pain that ranges from moderate to severe. Opioids can be safe and effective when used correctly. But they come with serious risks and side effects. They should be used only if other medicines or treatments haven't done enough to manage pain.

What is pain?

Pain is your body’s way of telling you something is wrong. It makes you pull your hand away from a flame or avoid walking on an injured leg. Pain starts in special cells called receptors found throughout your body. When you are sick or injured, these cells send signals to the brain. The brain interprets the signals as pain. In response, it sends back signals to protect the body. The brain also releases its own natural painkillers to help reduce pain. These painkillers are called endorphins. Once the source of the pain heals, the pain often goes away.

Types of pain

Pain can be 1 of 2 types: acute or chronic. Both types respond to treatment.

• Acute pain normally lasts fewer than 3 months. It goes away when the cause is treated. Common causes include injury or illness. Surgery can lead to short-term pain during healing. And women have acute pain during and after childbirth. Sometimes, acute pain can lead to chronic pain over time.

• Chronic pain often lasts longer than 3 months. This includes pain that comes and goes or is constant. Chronic pain may be due to an ongoing health problem, such as arthritis. Or it may linger after an injury that has healed, such as a broken bone. Problems with the body’s pain-control system may also lead to chronic pain. Sometimes, it can happen with no clear cause.

The pain cycle

Pain can affect all aspects of your life. Sleep, mood, activity, and energy level are all affected by pain. Being tired, depressed, or inactive makes the pain worse and harder to handle. This leads to a cycle of pain.

How opioids work

Opioids work by attaching to special receptors. These are found in the brain, spinal cord, and other organs. When that happens, opioids can relieve your pain. Opioids can also make you feel good or relaxed. They affect areas of the brain that produce feelings of pleasure.

Types of opioids

There are 2 types of opioids. They are short-acting/immediate-release (SA/IR) and long-acting/extended-release (LA/ER). Short-acting opioids work faster than long-acting opioids. But they give pain relief for only short periods. Long-acting opioids work slower than short-acting opioids. But they ease pain for longer periods. Many opioids come in both short- and long-acting formulas.

If you are prescribed opioids, you will likely be started on a short-acting type at the lowest dose. The dose may then be adjusted as needed. on your response to the medicine and follow-up with your provider. If needed, you may start using a long-acting type opioid. In some cases, you may be prescribed both types of opioids to help manage different types of pain. Any changes will also depend on how you handle pain and side effects from the medicine.

Side effects of opioids

Side effects of opioid medicines include:

• Constipation.

• Feeling sleepy (drowsy).

• Nausea.

Some side effects of opioid medicines can be life-threatening. Symptoms of opioid overdose include:

• Slow heart rate.

• Shallow or slowed breathing.

• Loss of consciousness.

When taking opioids, there is a danger of abusing the medicine. Physical dependence and addiction may happen. Take opioid medicines only as directed by your provider.

Note

Studies show that opioids give short-term help for moderate to severe pain. But the benefits of long-term use remain unclear. You should stay on opioids only if they continue to improve pain and function without raising the risks to your health.

How opioids are given

Most opioids are taken by mouth. They often come in pill form. But some may come as liquids and even sweetened lozenges. Some opioids also may be injected under the skin, into a muscle, or into a vein. Or they may be absorbed through the skin through a patch.

Know your choices

Keep in mind that opioids are not the only choice for treating pain. Nonopioid choices may work just as well. They may have fewer risks and side effects. Talk with your provider about which treatment plan is right for you. Nonopioid choices can include: 

• Other pain relievers. These include acetaminophen or nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen.

• Other types of medicines, such as anticonvulsants, antidepressants, and muscle relaxers.

• Exercise and physical therapy.

• Cognitive behavioral therapy. This can help you learn different ways to respond and cope with pain.

• Mind/body therapies, such as deep breathing, distraction, visualization, meditation, or biofeedback.

• Other therapies, such as massage, acupuncture and acupressure, or chiropractic care.

• Other procedures, as suggested by your provider.