Pain Medication: What Are Opioids?

Opioids are a type of pain medication made from the poppy plant. It is the same plant that is used to make opium and heroin. They are effective for treating acute or new pain after an injury or surgery. They are less effective for treating chronic pain, headaches, or nerve pain. They can also be used to treat cancer pain at the end of life.

Commonly used opioid pills include hydrocodone, oxycodone, hydromorphone, tramadol and codeine.

Misuse of Opioids: A Large and Growing Problem

Over the last 15 years, the prescription of opioids has increased tenfold. Misuse now kills more than 100 people each day in the United States. Opioids kill more people than both suicide and motor vehicle collisions combined. Nearly 16,000 Americans died of overdoses involving these pain relievers in 2009. Most of these deaths were accidental.

The Pain Problem

It is common for pain to occur after injury or surgery. Pain relievers do not take away pain all the way. They just make the pain less bothersome. Patients can develop tolerance to these drugs and sometimes get addicted. A higher tolerance means it requires more medicine to get the same amount of pain relief. When more medicine is used, the risk of side effects goes up. This is why opioids work well in the short term but can be harmful for long-term pain relief.

Figure 1: Opioids increase the drug receptors in the brain. This creates a greater need for the drug to achieve the same level of pain relief. If the drug is then not taken, much higher pain occurs.
Figure 1: Opioids increase the drug receptors in the brain. This creates a greater need for the drug to achieve the same level of pain relief. If the drug is then not taken, much higher pain occurs.

Recreational Use

Opioids can be, but should not be, used to get high. Over half of teens abusing these medicines get them from family or friends without their knowledge. In addition to potential poisoning, recreational use creates addiction. One study of heroin users found that 39% of addicts reported being “hooked” on prescription pain relievers first. Pain relievers should be kept in safe and secure locations to prevent their misuse.

Signs and Symptoms

The most common side effects of opioids are nausea, constipation, itching, and drowsiness. The most serious effect is a decrease in breathing, which can result in death. The chance of death can increase when pain relievers are used with alcohol or other drugs that make you sleepy.

Figure 2: Use extreme caution when taking opioids with alcohol or other medications. Substances that make you sleepy should not be taken with pain relievers.
Figure 2: Use extreme caution when taking opioids with alcohol or other medications. Substances that make you sleepy should not be taken with pain relievers.

Treatment

The progress of your treatment and your medication use should be discussed with your providers often. While they want to limit your pain after surgery or injury, they also understand the risks of abuse, addiction and death with these medicines. To reduce these risks, your provider may switch to over-the-counter medicines such as ibuprofen or acetaminophen once the initial intense pain subsides. In most cases you will need to stop using opioid pain medication before the pain is totally gone. A safe period of time to use opioids is often 3 days or less.

Disposal

Opioids should be disposed of when they are no longer needed to treat your injury or surgery. Studies report that 10% to 30% of pain relievers are never used. Leftover pain medicines kept at home increase the risk of accidental poisoning and drug abuse. These tragedies often affect family members or friends.

Some law enforcement agencies, pharmacies, and hospitals have drop boxes or have designated dates to collect pain medicines. Do not flush the pills down the toilet. Water treatment facilities do not effectively remove these drugs, so pollution of drinking water is a growing concern.

This mobile-friendly version is adapted from patient education content originally provided by the American Society for Surgery of the Hand.