McMaster University

Michael G. DeGroote
National Pain Centre

Scope of Search

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain

Appendix B-4: Opioid Information for Patients

NOTE: These messages could be used to create patient education materials.

Messages for Patients Taking Opioids

Note: Opioids are a group of similar medications that are used to help with pain — there is more than one type of opioid and they have different names for example, Percocet®, OxyContin®, Tylenol® No. 2, Tramacet®.

  1. Opioids are used to improve your ability to be active and reduce pain.
    • You and your doctor will set goals and ensure the medication is effective in achieving the goals, e.g. improving your ability to do the things you did before pain prevented you.
    • If you seem to benefit from the pain medication, your doctor will see you for follow-up visits to assess pain relief, any adverse effects, and your ability to meet your set activity goals.
  2. There are side effects from opioids, but they can be mostly controlled with increasing your dose slowly.
    • Common side effects include:
      • nausea (28% of patients report it), constipation (26%),
      • drowsiness (24%), dizziness (18%), dry-skin/itching (15%), and
      • vomiting (15%).
    • Side effects can be minimized by slowly increasing the dose of the drug and by using anti-nausea drugs and bowel stimulants.
  3. Your doctor will ask you questions and discuss any concerns with you about your possibility of developing addiction.
    • Addiction means that a person uses the drug to “get high,” and cannot control the urge to take the drug.
    • Most patients do not “get high” from taking opioids, and addiction is unlikely if your risk for addiction is low: those at greatest risk have a history of addiction with alcohol or other drugs.
  4. Opioids can help but they do have risks these can be managed by working cooperatively with your doctor.
    • Take the medication as your doctor prescribed it.
    • Don’t drive while your dose is being gradually increased or if the medication is making you sleepy or feel confused.
    • Only one doctor should be prescribing opioid medication for you — don’t obtain this medication from another doctor unless both are aware that you have two prescriptions for opioids.
    • Don’t take opioids from someone else or share your medication with others.
    • You may be asked for a urine sample this will help to show all the drugs you are taking and ensure a combination is not placing you at risk.
    • Your doctor will give you a prescription for the amount of medication that will last until your next appointment keep your prescription safe and use the medications as instructed if you run out too soon or lose your prescription your doctor will not likely provide another
    • If you cannot follow these precautions it may not be safe for your doctor to prescribe opioid medication for you.
  5. If you stop taking your medication abruptly, you will experience a withdrawal reaction.
    • Withdrawal symptoms do not mean you are addicted — just that you stopped the drug too quickly — your doctor will direct you on how to slowly stop this medication so you won’t have this experience.
    • Opioid withdrawal symptoms are flu-like, e.g., nausea, diarrhea, and chills.
    • Withdrawal is not dangerous but it can be very uncomfortable.
    • If you interrupt your medication schedule for three days or more for any reason, do not resume taking it without consulting a doctor.
  6. Overdose from opioids is uncommon, but you and your family should be aware of the signs.
    • Opioids are safe over the long term, BUT can be dangerous when starting or increasing a dose.
    • Overdose means thinking and breathing slows down — this could result in brain damage, trauma, and death.
    • Mixing opioids with alcohol or sedating drugs such as pills to help anxiety or sleeping, greatly increases the risk of overdose.
    • You and your family should be aware of signs of overdose — contact a doctor if you notice: slurred or drawling speech, becoming upset or crying easily, poor balance or, “nodding off” during conversation or activity.
  7. The medication the doctor prescribes for you can be very dangerous to others.
    • Your body will get used to the dose your doctor sets for you but this same dose can be very dangerous to others.
    • You have reached your proper dose slowly, but someone who is not used to the medication could have a serious reaction, including death — don’t give your medication to anyone else — it is illegal and could harm them.
    • Keep your medication securely stored at home — the bathroom medicine cabinet is not a safe place; research has shown that others, particularly teenagers might help themselves to these drugs from friends or relatives.