Are Any Opioids Safe? Risks of Long-Term Opioid Use

Opioids are a class of drugs, often referred to as narcotics, that are used to relieve pain. These medications are typically prescribed to treat chronic and acute pain caused by injury, surgery, and cancer. Milder forms of the drug may be used for arthritis or low back pain.

Opioids work by blocking pain signals between the brain and the body. In addition to controlling pain, opioids can be addictive due to their effect on making people feel relaxed, happy, or high.

Some of the most used opioids include:

• Prescription opioids
  • OxyContin and Vicodin
  • Fentanyl (a synthetic opioid)
  • Morphine
  • Hydrocodone
  • Tramadol
  • Methadone
• Heroin (an illegal drug)

Regular and long-term use of these prescription opioids can increase tolerance and dependence, requiring higher and more frequent doses. In some cases, this can even lead to addiction or opioid use disorder.

Other potential medical risks include:

• Limited ability to breathe (respiratory depression)
• Decrease in heart rate and blood pressure
• Drowsiness
• Nausea
• Vomiting
• Memory problems
• Serious fractures
• Breathing difficulty during sleep
• Hyperalgesia
• Immunosuppression
• Chronic constipation
• Bowel obstruction
• Myocardial infarction
• Tooth decay secondary to xerostomia
• Hallucinations

Opioids can be either short-acting or long-acting:

• Short-acting: Prescribed for pain that lasts only a few days
  • Takes 15-30 minutes to start working
  • Effect lasts for 3-4 hours
  • Examples include acetaminophen or ibuprofen
• Long-acting: Often called rescue medication and used for severe pain
  • Takes a little longer to work
  • Provides steady pain relief for 8-12 hours

Depending on the need, opioids can be administered in the following forms:

• Oral pill or liquid
• Nasal spray
• Skin patch
• Dissolvable pills under the tongue
• Suppository
• Intravenous (shot into a vein)
• Intramuscular (shot into a muscle)
• Epidural (shot into the space surrounding the spinal cord)
• Implanted pump

Some signs of overdose or overmedication include:

• Inability to stay awake or difficulty waking from sleep
• Excessive drowsiness
• Slurred speech
• Stumbling while walking
• Dizziness
• Confusion
• Trouble breathing, including slow, shallow breathing
• Limpness, lifelessness
• Pale or clammy skin
• Blue fingernails or lips
• Slow heartbeat leading to death (rare)

Although all medications should be taken with caution, extra care is required when taking opioids:

• Take the medication exactly as prescribed
• Do not take extra doses
• Do not break, chew, crush, or dissolve pills
• Store opioids in a safe place, away from the reach of children
• Dispose of unused medication properly
• Avoid driving or using machinery while on opiods
• Contact your doctor if you experience any side effects