Talking with Your Doctor about Prescription Opioid Painkillers   

Patients and prescribers really need to understand that opioids are highly addictive. It doesn't mean that they should never prescribe it or that the patient should never take it. It means we have to be very careful with these drugs." Dr. BlondellEvery patient should ask questions when getting a new prescription. This is especially important when your doctor, dentist or other health care professional prescribes you an opioid, such as hydrocodone, oxycodone, codeine and morphine.

It’s common for people to simply accept the recommendations of a doctor. Most of us aren’t well versed in talking with our health care providers about pain management. A person taking prescription opioids for any length of time—even for a few days after a dental procedure—should ask about opioid safety.

When properly used, opioids for pain can provide much-needed relief during the healing and recovery process. But uninformed use or abuse of opioids can lead to addiction and have devastating effects. It’s important to ask questions about pain management options and risks of opioid addiction. We know additional risk factors- genetics, family history, trauma, mental health, history of substance abuse, psychological/ social stressors – can increase risk of addiction. Providers should know these factors when considering medication options with patients.

 

What do individuals need to understand about treating pain but avoiding addiction?

Evidence is overwhelming that chronic use of pain medication shows little evidence for effectiveness and decreases an individual’s functioning over time. It can lead to an increase in depression and pain. Short scripts of pain medications can be effective, but long term alternative options should be considered and discussed.

 

What should I do if my physician prescribes an opioid?

Your doctor can tell you what an opioid is, and how to use it safely to relieve pain. People should be honest with their medical provider about their concerns, what medications they are currently taking and what other providers you may be working with. If you have potential or history of abuse, work with your provider on identifying a support plan for monitoring and dispensing your prescription.

 

Questions to ask your health care provider about opioid safety?

How does an opioid emergency, such as an accidental overdose, occur?

What kinds of things should I be doing to make sure I’m taking my opioid safely?

Can an opioid emergency still occur even if I take my prescription opioid as directed?

Are there any factors that may increase the chance of an opioid emergency that could cause my breathing to slow down or even stop?

What are the signs and symptoms of an opioid emergency?

“100 million Americans are suffering from chronic pain, so we really need to screen patients better for addiction, decrease the amount of opiates that we're prescribing, and find non-pharmacologic approaches to take care of our patients with chronic pain.Time with my doctor is so limited, how do I best ensure that we consider alternative options, which might not be covered by insurance?

In 2016 the Centers for Disease Control created the first national guidelines for prescribing opioids for chronic pain. A key recommendation encouraged doctors to use non-opioid approaches to treat most pain.

Advocate for increased communication with your provider and coverage options with your insurance company.  You can also do research on your own to identify other options and then schedule a time to review these findings with your physician.

 

If I do take a prescribed opioid, what should I look out for?

Do not take more pills than your doctor specifies, or more often. Do not save pills for later use. To protect others from addiction, do not give them to friends or family. Dispose of unused pills safely.

Signs of abuse including the following: if you start taking more than prescribed or more frequently than prescribed, begin to mix with other substances for increased effect, or begin taking medications for alternatives to pain (e.g. increased pleasure, sedation, or improvement in mood).

Talk to your doctor immediately if you or a family member show signs of addiction or dependence. Early detection can help stop the destructive cycle of addiction before it becomes too powerful to resist. Or talk to an addiction counseling organization.

 

Resources

Bring this opioid questions checklist for the U.S.Food & Drug Administration to your doctor’s office - What to Ask Your Doctor Before Taking Opioids: A Checklist

Discussing Prescription Opioid Painkillers with your Doctor  from the National Safety Council

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