The amount of opioid prescriptions in the US peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons. The rates have decreased since, but despite these reductions, the amount of opioids prescribed remains high. The Centers for Disease Control and Prevention (CDC) reports that in 2016, the total number of prescriptions dispensed in the US was more than 214 million, with a prescribing rate of 66.5 prescriptions per 100 persons. The generous prescribing habits of clinicians is particularly important, as CDC data also show that 40 percent of all US opioid overdose deaths involve a prescription opioid.
Opiate Agonists
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2 AnswersA
See All 2 AnswersBefore you start taking an opioid medication, talk to your doctor and pharmacist. Follow these tips:
- Tell your doctor about all the medications you take. Bring a list of the prescriptions, vitamins and herbal pills you take. This helps your doctor make sure your pain medication doesn't combine with your other medicines in a bad way.
- Talk with your doctor about your goals for reducing your pain and functioning better. You and your doctor can make sure the medication is helping you meet these goals. If not, your doctor can try a different medication or strategy.
- Talk with your doctor about your prescription. Ask questions. Be sure you understand what you're taking, why you're taking it and how to take it. Ask your doctor about the benefits, risks and alternatives.
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1 AnswerA
Dr. Devi E. Nampiaparampil, MD , Pain Medicine, answeredOpioids can be very helpful for acute pain management in the short term, but there are some side effects that make prolonged use risky. Watch me discuss for what types of pain opioid medications are best.
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2 AnswersA
NewYork-Presbyterian Hospital answeredSee All 2 AnswersBuprenorphine is the first medication for opioid maintenance and detoxification that physicians can dispense in their office. Buprenorphine is a partial agonist that blocks the effects of other opioids, and is taken sublingually (under the tongue). Buprenorphine interacts in similar, but significantly different ways at the same mu receptors in the brain where heroin, methadone, and prescription pain relievers, such as oxycontin, initiate their effects. This distinctive pharmacology gives buprenorphine its safety margin and low potential for diversion. It eliminates the major motivation for opioid abuse by preventing withdrawal symptoms and it produces less stimulation and physical dependence than full agonists.
Buprenorphine is also an effective pain medication, and has been used for this purpose for many years. It is 15 times more potent than injected morphine. The medication is different from other opioids so the client usually feels more "clear headed" when taking it. -
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See All 5 AnswersSide effects of opioid medication can include:
- Constipation, the most common side effect
- Decreased breathing, the most serious side effect
- Sleepiness, tiredness, and/or dizziness
- Itching and/or sweating
- Nausea, vomiting, and/or dry mouth
- Slower reactions (physical and mental) that can reduce alertness or judgment
- Depression, feeling generally "low," feeling "high," and/or seeing or hearing things that aren't there
- Difficulty urinating
- Low levels of testosterone (a hormone); low levels can result in lower sex drive, energy, strength, or bone mass
- Altered taste, vision, heart rate, and/or blood pressure
- Shaking and/or twitching
- Becoming more sensitive to pain
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1 AnswerA
Dr. Darria Gillespie, MD , Emergency Medicine, answeredTramadol (Conzip, Ultram) is a weak narcotic pain medication. It is sometimes prescribed for people with fibromyalgia pain. It is less likely to cause dependence than stronger narcotics. Tramadol has been used and studied as a treatment for fibromyalgia, but is not FDA-approved for this use.
This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. -
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Dr. Darria Gillespie, MD , Emergency Medicine, answeredBefore prescribing an opioid for low back pain, your doctor should order a urine test to check for other drugs you might be taking. Your doctor should also talk to you about how to measure how well the drug is controlling your pain, side effects, and when and how you will stop taking it. A follow-up appointment should be scheduled for 1 to 2 weeks after you start taking the drug.
If you take an opioid, you should not drink alcohol. Mixing alcohol and opioids can cause a fatal overdose. If you take methadone, you should avoid grapefruit and grapefruit juice.
If you have had gastrointestinal surgery in the past few months, an opioid may not be a good option for you.
If you have a seizure disorder (epilepsy), aspirin-sensitive asthma, or chronic lung disease, opioids can lead to serious side effects.
If you have an abnormal heart rhythm (arrhythmia), hypothyroidism, impaired kidney function, impaired liver function, or primary adrenocortical insufficiency (Addison disease), an opioid may not be a good option for you.
Because of their potential for abuse and dependence, opioids are not a good option for people who have had a substance use problem, or for people with psychiatric conditions, such as depression.
An opioid may not be a good option for you if you are pregnant, may be pregnant, or are planning a pregnancy. It is not known if they are safe for pregnant women.
Some opioids may not be safe or effective for children and adolescents. Consult individual drug labels.
If you are breastfeeding, an opioid may not be a good option for you.
This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. -
1 AnswerA
Dr. Darria Gillespie, MD , Emergency Medicine, answeredIf you are taking a benzodiazepine, mifepristone, or sodium oxybate, you should not take opioids.
If you are taking acyclovir, meperidine may not be a good option for you.
If you are taking carbamazepine, tramadol can lead to side effects and should be avoided.
If you are taking an anticholinergic drug, an azole antifungal drug, cimetidine, a CYP3A4 inducer, perampanel, or a phenothiazine, an opioid may not be a good option for you.
If you are taking amiodarone, a drug that prolongs the QTc interval, a selective serotonin reuptake inhibitor, or tricyclic antidepressant, opioids can lead to serious side effects.
If you are taking a protease inhibitor, meperidine can lead to side effects and should be avoided.
You should not take an opioid while taking MAO inhibitors or until at least 2 weeks after stopping MAO inhibitors.
This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. -
1 AnswerA
Stacy Wiegman, PharmD , Pharmacy, answeredYou should not take nalmefene hydrochloride if you are currently taking flumazenil or nalbuphine. Also avoid this medication if you are allergic to it or any of its ingredients, have liver or kidney disease, heart disease for which you take medication, or a history of narcotic addiction. Pregnant and breast-feeding women should not take this drug if possible.