Opioids are a type of pain medication made from the poppy that is used to make opium and heroin. People have used them to treat pain for thousands of years. They are effective for treating acute pain involving skin, muscle, or bone and joint pain in the first several weeks following injury or surgery and are less effective for treating chronic pain, headaches or nerve pain. They are sometimes used to treat cancer pain at the end of life. Some of the most common such pain relievers used today include hydrocodone, oxycodone, hydromorphone, tramadol and codeine.
Over the last 15 years, the prescription of opioids has increased tenfold. Misuse now kills more than 100 people each day in the United States. It is responsible for more deaths than both suicide and motor vehicle collisions combined. According to the Food and Drug Administration (FDA), nearly 16,000 Americans died from overdoses involving these pain relievers in 2009. Most of these deaths were accidental.
Pain is expected after injury or surgery, and mindset matters. Pain relievers cannot take pain away; they just make the pain less bothersome. Patients quickly develop tolerance to these drugs, which means it requires more medicine to achieve the same amount of pain relief as time goes by. This is why such pain relievers work well in the short term, but do not work for long-term chronic pain.
Opioids are sometimes used by patients or their friends to get high. Over half of the teens abusing these medicines get them from family or friends without their knowledge. In addition to potential poisoning, recreational use creates addiction. One study of heroin users found that 39% of addicts reported being “hooked” on prescription pain relievers first.
The most common side effects of opioids are nausea, constipation, itching and drowsiness. The most serious effect is a decrease in breathing, which can result in death. The chance of death can increase when pain relievers are used together with alcohol or other drugs that make you sleepy.
The progress of your treatment and your medication needs should be discussed with your providers, including your surgeon, physician assistant and nurse. While your providers want to limit pain following surgery or injury, they also understand the risks of abuse, addiction and possibly death associated with the use of these medicines. To reduce these risks, your provider may suggest switching to over the counter medicines such as ibuprofen or ancedimenifin once the initial intense pain subsides.
Opioids should be disposed of when they are no longer needed to treat the injury or surgery for which they were originally prescribed. Studies report that between 10% and 30% of these pain relievers sold go unused. Leftover pain medicines kept in a patient’s home increase the risk of accidental poisoning and drug abuse. These tragedies often affect family members or friends.
Many communities have organized ways to dispose of unused pain relievers. Some law enforcement agencies have drop boxes or hold designated dates to collect unused prescription medicines. Do not flush the pills down the toilet because it releases the drugs into the waterways. Water treatment facilities do not effectively remove these dissolved drugs, so contamination of drinking water is a growing concern.
© 2017 American Society for Surgery of the Hand
This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.Find a hand surgeon near you.