Opioids: What You Need to Know

This information explains what opioids are and how to take them safely.

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What are opioids?

Opioids are strong painkillers that your healthcare provider (such as your doctor or advanced practice provider) prescribes to you for moderate to severe pain. While opioids come with some risks, they can help you manage your pain. It’s important to follow your healthcare provider’s instructions and the tips in this resource when taking opioids.

You may be prescribed opioids when other medications don’t help with your pain or may interfere with your cancer treatment. Opioids can help you manage your pain so that you’re able to do your daily activities and improve your quality of life.

Some commonly prescribed opioids are:

  • Hydrocodone (Vicodin®)
  • Oxycodone (Percocet, Oxycontin®)
  • Hydromorphone (Dilaudid®)
  • Morphine (Duramorph)
  • Fentanyl patch (Duragesic)
  • Buprenorphine
  • Methadone
  • Codeine (Codeine Sulfate)
  • Tramadol (Ultram®)
  • Methadone (Dolophine®)
  • Meperidine (Demerol®)
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What is the opioid epidemic?

The opioid epidemic refers to the recent increase in opioid addiction (a strong urge to use a substance) and opioid-related deaths. This is caused by opioid misuse. Opioid misuse is when you:

  • Take your opioids differently than how your healthcare provider prescribes
  • Take someone else’s opioids
  • Take opioids when you don’t need them

You can safely manage your pain with opioids by following your healthcare provider’s instructions.

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How can I take opioids safely?

You can take opioids safely by following these tips.

  • Take them as prescribed. Follow your healthcare provider’s instructions when taking opioids. Don’t take your opioids in greater amounts or more often than your healthcare provider instructed.
  • Make a list of all your medications. This list should include all opioids, other medications, and dietary supplements (such as herbs, vitamins, or home remedies) that you’re taking. Keeping track of the names, dose amounts, and how often you take them is important. Bring this list with you to all your appointments.
  • Avoid drinking alcohol and using recreational drugs while taking opioids.
  • Store them safely. Keep your opioids in a safe place (such as in a locked cabinet) and out of reach of others (this may include visitors, children, friends, pets, and family).
  • If you don’t need them, don’t keep them. Get rid of your unused or expired opioids when you don’t need them anymore. For more information, read the section called “How can I get rid of my unused opioids?”
  • Only take opioids prescribed to you. Don’t share your opioids with another person or take another person’s opioids.
  • Talk to your healthcare provider about changing your dose. Stopping opioids suddenly can cause you to have side effects from medication withdrawal. This doesn’t mean you’re addicted. It’s a normal reaction when you stop taking medication too quickly. If you want to increase, decrease, or stop taking opioids, ask your healthcare provider how to do it safely.
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How will I know if I’m getting addicted?

Although addiction in people with cancer-related pain is rare, it’s possible. Being addicted feels like an uncontrollable urge to take opioids, even without having pain.

Talk to your healthcare provider if you think you may be at risk for addiction. Some common risk factors for addiction include:

  • Having a personal or family history of substance abuse
  • Being 45 years of age or younger
  • Depression (having strong feelings of sadness)
  • Anxiety (having strong feelings of worry or fear)
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Where can I go for help?

If you’re concerned about getting addicted or have questions about taking opioids, talk to your healthcare team. This includes your doctors, nurses, and social workers. They can help you get the care you need.

At Memorial Sloan Kettering (MSK), we talk with everyone about their risk for opioid misuse. We provide additional support for people who need treatment for opioid misuse at MSK or an outside treatment center. For more information, visit the websites below.

Center for Disease Control (CDC)
www.cdc.gov/drugoverdose
Visit their website to learn more about the risks of opioid abuse and overdose.

 

Substance Abuse and Mental Health Services Administration (SAMHSA)
800-662-HELP (800-662-4357)
www.samhsa.gov/find-help/national-helpline
SAMHSA’s National Helpline is a free, confidential referral and information phone service for people facing mental or substance use disorders and their families. The Helpline is open 24 hours a day, 7 days a week, and is available in English and Spanish. Call or visit their website for more information.

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What are common side effects?

You may have side effects while taking opioids. The following are common side effects, but there can be others. Talk with your healthcare provider if you have any concerns about side effects. Opioids can cause:

  • Constipation (having fewer bowel movements than usual). For more information about how to manage constipation, read our resource Constipation.
  • Nausea (feeling like you will throw up) or vomiting (throwing up). This usually gets better in a few days.
  • Sleepiness that gets in the way of your daily life. If this doesn’t get better in 3 to 5 days, call your healthcare provider.
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Why might side effects be greater for older adults?

  • Older adults may have more medical conditions which means they might need to take more medications than younger adults.
  • If you take opioids, you may feel drowsy and have a greater risk of falling. Falling can be even more dangerous for older adults. Older adults should be careful while taking opioids. They may need to use something to help them stay balanced, such as a cane. For more information, read our resource What You Can Do to Avoid Falling.
  • Memory loss can be present in older adults. For people with memory loss, taking opioids may lead to:
    • Increased confusion
    • Sleepiness
    • Hallucinations (sight, sound, smell, taste, or touch that a person believes to be real, but it’s not)

If you have any of these side effects, talk to your healthcare provider.

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How can I get rid of my unused opioids?

It’s important to get rid of your unused or expired opioids when you don’t need them anymore. This helps you make sure you don’t take more opioids than you need and lowers the chances that someone else might take them. It’s important to know how to get rid of them.

To get rid of your opioids, use one of these options:

  • Find out about prescription drug take-back programs from your local pharmacy, recycling coordinator, or town.
  • Find a controlled substance public disposal location near you by using the Drug Enforcement Administration Diversion Control Division’s website bit.ly/2TGiC86 or call 800-882-9539.
    • You can also find out about prescription drug take-back programs from your local pharmacy, recycling coordinator, or town.
  • Bring your opioids to a National Drug Take-Back Collection day. This event happens twice a year. For more information about this program, visit the Drug Enforcement Agency (DEA) website at takebackday.dea.gov.
  • Some opioids can also be flushed down the toilet. Check to see if your opioid is on the approved list and can be flushed by visiting bit.ly/2VigSCB.

If you would like to get rid of your unused or expired opioids at MSK, you can bring them to MSK’s drop off location at the 425 East 67th Street entrance of the Haupt building in Manhattan.

For more information, read our resource Getting Rid of Unused Medications.

 
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What are other ways I can manage my cancer pain?

Talk to your healthcare team about other ways to manage your cancer pain that don’t include opioids. Some of these options may work better for you and have fewer risks and side effects. Other options may include:

  • Taking other types of pain medication, including over-the-counter medication, such as acetaminophen (Tylenol®), ibuprofen (Advil®), or naproxen (Aleve®), or other non-opioid prescription medications. Remember to talk with your healthcare team about what medications you’re taking even if they are over-the-counter.
  • Having a nerve block procedure done (procedure to stop your nerves from sending pain messages to your brain).
  • Scheduling an appointment with the Integrative Medicine Service. Integrative medicine therapies combine natural treatments, such as acupuncture, massage, and yoga, into your overall cancer pain management plan. For more information, read our resource Integrative Medicine Therapies and Your Cancer Treatment or call 646-888-0800.
  • Physical therapy and exercise. Ask your healthcare provider if physical therapy and exercise can help you manage your cancer pain.
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