This resource has important information about PACT and taking opioids safely. In this resource, the words “you” and “your” refer to you or your child.
PACT’s approach to pain
We design a pain management plan for you and your type of pain. The best way to treat pain is to use many different tools. Medicines are just one of the many tools we use. We also use physical and occupational therapy, mental health treatments, procedures, and integrative medicine treatments.
Managing pain with opioids
Opioids are strong pain medicines prescribed to help with some types of pain. All opioids work in similar ways and have similar side effects. Short-acting opioids work for 3 to 4 hours. Long-acting opioids work for longer.
Some commonly prescribed opioids are:
- Morphine: Duramorph® (short-acting), MS Contin® (long-acting)
- Oxycodone: Oxycontin® (long-acting), Xtampza ER® (long-acting)
- Hydromorphone: Dilaudid® (short-acting), Exalgo® (long-acting)
- Fentanyl: Actiq® (short-acting), Fentora® (short-acting), Duragesic® (long-acting)
- Methadone (long-acting): Dolophine®
Opioids are not the right medicine for every type of pain. We will give you the medicines that work best for the type of pain you’re having.
Opioid side effects
Opioids can be very helpful, but they come with important side effects and safety concerns. A PACT provider will talk with you about the risks and benefits before you start taking opioids.
These are the most common side effects:
- Constipation (pooping less often than usual)
- Itching all over your body
- Nausea (feeling like you’re going to throw up)
- Vomiting (throwing up)
- Feeling sleepy
- Feeling dizzy or lightheaded
These are less common side effects:
- Swelling in your legs
- Trouble breathing
- Trouble thinking clearly
- Loss of coordination (having a hard time controlling parts of your body)
- Lower levels of estrogen and testosterone (reproductive hormones)
- Memory problems
- Hot flashes or chills
Opioids can also cause tolerance, dependence, withdrawal, and substance use disorder (addiction).
Opioid tolerance, dependence, and withdrawal
Tolerance is when your body gets used to a medicine. When that happens, you need a higher dose (amount) to get the same result. This usually happens after using opioids for a long time.
Dependence is when your body is so used to a medicine that it can cause symptoms. When that happens, you have uncomfortable symptoms if you stop taking a medicine suddenly or lower your dose too quickly. These symptoms are called withdrawal.
Withdrawal symptoms include:
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Opioids can cause tolerance and dependence even if you take them in the right way. Opioid withdrawal is unpleasant, but not harmful. We’ll help you lower your dose or stop taking opioids in a way that lowers your chance of withdrawal.
Opioid misuse and addiction
Misuse is taking a medicine in a different way than your healthcare provider prescribed. Examples of misuse are:
- Taking a higher or lower dose than your healthcare provider prescribed.
- Taking a pain medicine for reasons other than pain.
Addiction is a strong urge to take a medicine. It can feel like you’re losing control of how much medicine you take or how often you take it. It can make you crave the medicine or find yourself thinking about taking it all the time. It can also make you keep taking medicine even if it’s harming your health or other parts of your life.
Opioids can be addictive if you in a different way than your healthcare provider prescribed. We take steps to make sure we prescribe opioids safely. We keep the risk of misuse or addiction as low as possible.
What to do when taking opioids
- Follow our instructions for taking your medicines.
- Do not change your opioid dose or schedule without talking with a PACT provider.
- You should only get your opioids from PACT. Tell us if another healthcare provider prescribes opioids for you, such as in an emergency.
- Store your opioids safely. It’s best to store them in a safe or lockbox.
- Do not drink alcohol or use recreational drugs.
- Do not drive.
- Do not do activities that can harm you if you’re not alert.
- Tell us at least 24 hours (1 day) ahead of time if you need to reschedule an appointment.
- Follow our instructions for refilling your medicines.
What to expect in the PACT clinic
You must have an in-person visit if you’re new to the PACT clinic. You also must come in if your last visit was more than 1 year ago. Once we prescribe opioids, you must have an in-person visit every 3 months.
We will screen you for substance misuse risk before we prescribe opioids. We repeat this screening while you’re taking opioids to make sure you stay safe. This screening may include 1 or more of these:
- Questions about substance misuse or addiction for you or your family.
- Questions about mental health conditions. Some may raise your risk of a substance use disorder.
- Urine (pee) tests.
- Pill counts.
We may choose to stop prescribing a medicine. We will make this decision based on your situation. We also will assess how taking the medicine helps or harms your health.
Requesting a prescription refill
- Tell us at least 5 days before you run out of your medicine. You can call us or send us a message on MyMSK (MSK’s patient portal).
- We cannot refill prescriptions at night (between 5 p.m. and 8 a.m.) or on weekends.
- The amount of medicine in each refill will depend on your needs and your safety.
- If you lose your opioids, we will refill the prescription 1 time only.
- If your opioids are stolen, contact the police. Send us a copy of the police report. We cannot prescribe more opioids until we see the report.
PACT contact information
From to Monday to Friday, call 212-639-5607 or send us a message on MyMSK. All other times, contact your MSK primary care team. If you’re not sure how to reach them, call 212-639-2000.
In an emergency, call 911 or go to your local emergency room.
