Opioid medication is prescribed when initial treatment with other pain relief medicines, such as paracetamol, is only partially effective.
Opioid medication
- weak opioids include: codeine and tramadol
- strong opioids include: morphine, oxycodone, fentanyl, alfentanil, hydromorphone and buprenorphine
- opioids are often used in combination with other non-opioid medications to relieve pain
Your opioid medicine
It is important you take your opioid exactly as prescribed. You could make a note of the following, to help you manage how you are taking your medicine:
- Regular, slowly released medication: name and form of your opioid medicine, and your dose and frequency (times).
- Quicker acting, immediate release medication: name and form of your opioid medicine, and your opioid dose and frequency (times).
Time of action
Opioid medication is available in different forms:
Long acting: Some opioid medications are available as modified released forms, which slowly release the drug and relieve pain for up to 12 hours. It is important that these modified release opioids are taken regularly, at the same time each day, to get the best effect. A combination of slow release and quick acting opioids medicines are often prescribed to optimise pain relief.
Short acting: Quicker acting (immediate release) opioid medication is usually effective in half an hour. The effect of these quicker acting opioids may last for 4 to 6 hours. These quicker acting opioids are usually prescribed for relief of breakthrough pain.
Injections: For those individuals who struggle to take opioid medication by mouth, opioid injections may be given by a nurse. These injections may also be given using a continuous infusion, known as a syringe pump, over 24 hours to reduce the need for repeated injections.
Patches: Sometimes it is appropriate for stable pain to be managed with regular opioid medication in the form of patches. These patches need to be replaced regularly every few days according to the prescription. Avoid exposure of the patch to heat eg, a hot water bottle or bath and ensure the patch is not accidentally transferred to another person.
Possible side effects of opioids
- constipation is a common side effect and laxatives should be prescribed to prevent this
- vomiting or feeling sick – anti-sickness medicines are often prescribed to minimise this. This side effect usually wears off after a few days
- drowsiness
- feeling confused
- hallucinations
- itching
- loss of sex drive
These possible side effects may only be temporary but may require other medications to help manage them if they persist. The need for additional medicines to reduce side effects will be reviewed by your Doctor, Specialist Nurse or Pharmacist.
Contact your GP, Specialist Doctor, Specialist Nurse or Pharmacist if you experience any of the following:
- increasing sleepiness, confusion, drowsiness or hallucinations
- the pain does not get any better or worsens
- if you are unsure about your medication
Frequently asked questions
Can I take opioids for a long time?
The opioids you are taking will be reviewed by your Doctor or Specialist Nurse. It may be possible to reduce or stop opioids if your pain reduces. However if your pain continues then it is recommended you continue with the opioid medication and the dose will be reviewed.
Is there a maximum dose?
It may be that the dose of opioid will vary and possibly be increased over time, following review. Do not suddenly stop taking your opioids. The dose will be adjusted according to the nature of your pain and the presence of any other medical conditions you may have.
Will I become addicted?
You will not become addicted if you always take your opioid medication as prescribed to relieve pain and your dose is closely monitored by your Doctor or Specialist Nurse.
How should I store the opioid medication?
Like all medication, store opioids in a dry, cool place out of sight and the reach of children, pets and vulnerable adults.
Can I drink alcohol whilst taking opioids?
Taking alcohol and opioids together can cause increased drowsiness. When you first start taking the opioid or when the dose is increased you should not drink alcohol until you have established the effect the opioid dose has on you. If you are on a stable dose of opioids you may take alcohol in moderation but be aware of the increased likelihood of drowsiness.
Can I drive whilst taking opioids?
- all medicines affect people differently. Taking opioids does not mean that you must not drive altogether
- if you are on a stable dose of opioid medicine and your symptoms are well controlled you may be safe to drive
- recent changes to ‘Drug Driving Laws’ mean you may be prosecuted if you are taking opioids and your driving is impaired
- when you start taking an opioid or the opioid dose is increased or when a new medicine is started or the dose of another medicine you are prescribed is increased; check with your Pharmacist, Doctor or Specialist Nurse regarding the effect this prescription change can have on your existing medication and your ability to drive safely
Record keeping
It is recommended that you keep a record of the regular opioid doses you take and how often you need to take any quick acting opioid medicines. This record will prove very informative for future medication review by your GP, Specialist Doctor, Specialist Nurse or Pharmacist to assist them in optimising your prescription for pain management.
Further information
There is a full description of your opioid medicine in the patient information leaflet, which comes with your medication when it is dispensed. Further advice is available from your Pharmacist, GP, Out of Hours GP or Specialist Nurse if required.
The patient/representative may be asked to show identification when collecting opioid medication from the community pharmacy. All unused opioid medication should be returned to any community pharmacy for disposal.
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