Eight Steps

8 Opioid Safety Points for Patients

You have been prescribed opioids for your pain. These strong medications contain narcotic-like substances that provide good pain relief but can cause harm if used improperly. Opioids depress breathing and can lead to overdose and death. To keep yourself and your family safe, follow these important safety tips.

  1. Never take an opioid pain medication that is not prescribed to you
    Everyone responds differently to pain medications. What is safe for one person may not be safe for another. Government statistics show that many people share their medications and that such sharing leads to great harm (1).

  2. Never adjust your own doses
    Even after the effects of the opioid seem to have worn off, the medication may still be depressing your breathing (2). The body must develop a tolerance to the effects on breathing before the dose can be increased. Only a healthcare provider knows whether it is safe to increase the dose. Remember, opioid medications cannot be expected to remove all pain. If you are still in pain, talk to your healthcare provider about safer ways to control the pain. Never take opioid medications to relieve stress or because you feel depressed or anxious. Talk to your healthcare provider about ways to handle these problems separate from your pain medications.

  3. Never mix with alcohol
    This dangerous combination can be deadly. This is because alcohol increases the toxicity of opioid pain medication. Most overdose deaths from opioids also involved at least one other drug (3). Alcohol is one such contributor to prescription-drug deaths.

  4. Taking sleep aids or anti-anxiety medications together with opioid pain medication can be dangerous
    Sleep aids and anti-anxiety medications are often found together with opioids in the blood of people who died from prescription-drug overdose (3). Combining pain medications with sedative drugs, such as Valium, can increase the toxicity of the pain medication. Remember, prescription pain medications can suppress breathing during sleep. If you have anxiety, pain at night or trouble sleeping, speak to your healthcare provider about safer methods to manage these problems.

  5. Always tell your healthcare provider about all medications you are taking from any source
    Certain medications can react by either increasing or reducing the effect of opioids in your body. Danger is possible when drug-drug interactions occur (4). Your healthcare provider must know about all medications and natural supplements you are taking, whether they are prescribed or purchased over-the-counter. Only take other medications if directed by your prescribing provider.

  6. Keep track of when you take all medications
    Track your use of all prescribed medications, over-the-counter drugs and natural supplements. To do this, write down all prescriptions to be taken longer than two weeks, noting the date the medication was added or changed, the medication name, the dosage, how often to take it, the reason for taking it and the doctor who prescribed it (5). Keep this record in a safe place, and show it to your pharmacist whenever a medication is added or changed.

  7. Keep your medications locked in a safe place
    If consumed by children or other family members, or stolen and sold on the street, prescription pain medication can kill. Statistics show that seven out of 10 opioids that were used for recreation or another nonmedical purpose were taken from family medicine cabinets or shared with family members (1). Do not contribute to this danger. Never share your pain medications with anyone and secure them in a locked box or cabinet.

  8. Dispose of any unused medications
    Leftover pain medications make tempting targets for theft. They can also be dangerous if found by children. Many communities offer places for you to drop off unused medications. Some states even sponsor special “take-back” events. Check with your pharmacist or with your local recycling service for locations and times or visit www.takebacknetwork.com. If no take-back program is available, experts recommend flushing leftover opioids down the toilet (6). While flushing is not recommended for most medications, leftover opioids are so risky that it is best to remove them from your house in this way. First, be sure your state or local laws do not prohibit flushing medications. When in doubt about proper disposal, check with your pharmacist.

References


1. Substance Abuse and Mental Health Services Administration, Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2011.

2. U.S. Food and Drug Administration. Public Health Advisory: Methadone Use for Pain Control May Result in Death and Life-Threatening Changes in Breathing and Heart Beat. U.S. Department of Health & Human Services. Silver Spring, MD’ 2006.

3. Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999-2006. NCHS Data Brief 2009; (22):1-8.

4. Wright A, Feblowitz J, Phansalkar S, et al. Preventability of adverse drug events involving multiple drugs using publicly available clinical decision support tools. Am J Health Syst Pharm. 2012; 69(3):221-7.

5. Iowa Healthcare Collaborative: Consumer Resources, Medication Card. 2010. Available at: www.ihconline.org.

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Media Coverage

November 16, 2012
Physicians take lead role in confronting opioid misuse, but still face hurdles: This is the second in a series exploring the intersections between effectively caring for people living with chronic pain and the rise in unintentional poisoning deaths due to prescription painkillers. (The first post is here.) The series will explore the science and policy of balancing the need for treatment as well as the need to prevent abuse and diversion. This week’s story looks at clinical efforts to reduce the risk of opioid abuse and overdose while still caring for patients; the next story will explore the role of public health officials in curbing opioid abuse. Read More

November 14, 2012
AMA webinar spells out 8 ways physicians can curb opioid misuse: The Association holds the first in a series of webinars to teach doctors more about appropriate pain management. Read More

September 17, 2012
FDA Warns of Serious Skin Burns from Topical Pain Relievers: FDA Warns of Serious Skin Burns from Topical Pain Relievers Read More

July 3, 2012
Methadone deaths may have peaked, feds say: CDC » Doctors are more cautious about prescribing methadone for pain because of federal, state warnings. Read More

April 9, 2012
Filling In the Gaps on Pain Prescriptions: Filling In The Gaps On Pain Prescriptions Read More

April 5, 2012
Opioid Rotation Practices Linked to Fatalities: Opioid Rotation Practices Linked to Fatalities Read More

April 3, 2012
Switching Opioids Increases Risk of Overdose Death, Study Says : Switching Opioids Increases Risk of Overdose Death, Study Says Read More

April 2, 2012
Changing Opioids Causing More Overdose Deaths : Changing Opioids Causing More Overdose Deaths Read More

April 1, 2012
Doctors kill thousands due to 'death tables,' Utah expert says in new study : Reference tool responsible in death toll from prescription painkillers Read More

April 1, 2012
Opiate conversion charts killing patients : Opiate conversion charts killing patients Read More

March 8, 2012
What Whitney Houston Teaches Us: Whitney Houston has died from an as-yet unknown cause, but prescription medications are rumored. Her struggles with substance abuse are well documented, because she honestly shared them with the public in hopes of finding her road back. Celebrity deaths bring to our attention the national public health crisis with prescription drugs, and the list is growing: Health Ledger, Anna Nicole Smith, Corey Haim, Mike Starr. These people are not apart from or above us but hold a mirror up to our own lives. Most healthcare practitioners and counselors know a client, a friend or even a family member who has met the same tragic fate. Read More

March 2, 2012
LifeSource Co-Founder Lynn R. Webster, M.D. Receives Inaugural AAPM Presidential Excellence Award for Education: The American Academy of Pain Medicine initiates award to honor Dr. Webster’s work on the AAPM Safe Opioid Prescribing Initiative. Read More

January 12, 2012
The Chronic Pain Problem : Millions of Americans are affected by debilitating chronic pain, and diagnosis and treatment remain a challenge. Read More

November 2, 2011
Study shows Utah a leading state in painkiller deaths : A new study shows that painkiller abuse has not only reached epidemic levels in the United States, but overdose deaths continue a disturbing rise. Read More

November 1, 2011
Prescription Painkiller Overdoses in the US: Overdose deaths from prescription painkillers have skyrocketed during the past decade. Read More

September 14, 2011
Family: Player died from methadone overdose: Family members say a North Carolina high school quarterback died after a big victory last month after accidentally overdosing on some of his grandmother’s pain medication. Read More

August 26, 2011
Dr. Webster Pain Med Safety Interview: Host: Dr. Brian Grieves Radio station # (715) 524-2194 About: Dr. Brian Grieves is a radio show host at WTCH-AM, an affiliation WOTE-AM, both radio stations at Wisconsin. Every Saturday he gives his professional advice on "Health Talk" to his avid listeners in Shawano. Prior to working as a chiropractor, Grieves earned his Bachelors degree from the University of Wisconsin, a doctorate degree from Northwestern College, and his Masters Degree in Public Health from the University of Massachusetts. Read More

June 30, 2011
Dramatic increase of prescription-drug abusers seeking treatment: Dr. Webster joins KCPP to discuss trends in prescription drug abuse. Read More

June 23, 2011
'Rapid detox' a quick fix for opiate addiction?: USA Today Read More

June 15, 2011
LIFESOURCE ANNOUNCES NEW STUDY FINDINGS AVAILABLE ON DEATHS RELATED TO PRESCRIPTION OPIOD THERAPY: Nonprofit organization strives to address one of the nation’s biggest healthcare problems Read More

April 27, 2011
American Pain Foundation Announces New NSAID and Acetaminophen Pain Medication Safety Module and Public Service Announcement for PainSAFE Read More

April 20, 2011
U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work?: U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work? By MAIA SZALAVITZ Wednesday, April 20, 2011     The Obama administration announced on Tuesday a new initiative to reduce prescription painkiller Read More

April 19, 2011
Striving Toward Quality Pain Management: The epidemic of untreated chronic or recurrent pain has lasted for decades, yet millions of people are still not adequately treated. One significant barrier to effective pain management is that clinicians and patients are often reluctant to talk about pain... Read More

April 11, 2011
National Prescription Drug Abuse Expert From Utah To Present At Public Town Hall Meeting In Reading: Medical experts and law enforcement provide insights on adolescent prescription drug addiction Read More

March 22, 2011
National Prescription Drug Abuse Experts To Meet With White House Policy Makers: Experts will address prescription pain medication misuse and accidental overdose deaths with the White House Office of National Drug Control Policy Read More

March 10, 2011
National Prescription Drug Abuse and Overdose Deaths Expert Addresses Healthcare Professionals In Houston: Lynn R Webster, M.D. Read More

February 12, 2011
For Some Troops, Powerful Drug Cocktails Have Deadly Results: February 12, 2011 This article was reported by James Dao, Benedict Carey and Dan Frosch and written by Mr. Dao.   In his last months alive, Senior Airman Anthony Mena rarely left home without a backpac Read More

February 5, 2011
There are ways to help, prevent prescription drug abuse:   CHARLESTON, W.Va. -- Recently The Charleston Gazette ran a series on the emerging epidemic of prescription drug abuse. In a state with the highest rate of drug-related deaths, highlighting prescription drug abuse is an important public Read More

January 24, 2011
Morphine/Oxycodone Combination Superior to Separate Components: Montreal Read More

January 20, 2011
I Am An Addict:   Millions of older Americans are making this confession. Families are being torn apart. The good news: There's help Clean and sober for more than five years, Ron Dash has rebuilt his marriage and his life. “When I saw what Read More

January 10, 2011
Patients suffer when doctors are too scared to prescribe pain pills : Patients suffer when doctors are too scared to prescribe pain pills Monday, January 10, 2011; 8:36 PM    Every American should be concerned about the kind of message sent by the Jan. 2 front-page article "Doctors who pre Read More

December 15, 2010
Chronic pain patients, providers get new website:       Kathy Hahn Read More

December 9, 2010
Should an Overdose Antidote Be Made More Accessible?:   I've been writing about naloxone — the antidote to overdose of heroin, oxycodone or similar drugs — for more than 10 years, most recently for TIME here. The dru Read More

November 9, 2010
Addiction to painkillers hobbles more patients : ST. LOUIS — Nichole Marie Case unwittingly became dependent on opioid painkiller drugs. She's not alone. The National Institute on Drug Abuse estimated in 2008 that 1.85 million people in the United Stat Read More

October 25, 2010
Opioid safety is focus of $1 million-a-year educational initiative :   Opioid safety is focus of $1 million-a-year educational initiative Industry-supported PainSAFE targets how physicians and patients can avoid abuses and misuses of pain treatments. A group that represents patients living with pai Read More

February 11, 2010
The Effect of Academic Detailing on Curbing Opioid-Related Deaths in Utah

February 11, 2010
Root Cause Analysis for Unintentional Overdose Deaths Involving Opioids in Chronic Pain Patients Reveals Disproportionate Methadone Involvement

February 11, 2010
Costs of Oral Pain Medications Pre-IT Pump Implantation Compared to Post-IT Pump Implantation: A Retrospective Analysis

February 11, 2010
Select Medical-Legal Reviews of Unintentional Overdose Deaths

February 11, 2010
Comparison Of The Theoretical Cost Of Morphine And Prialt

November 18, 2009
To Help Healing, Doctors Pay More Attention to Pain. Morning Edition. National Public Radio.: The old notion that pain is somehow "good" for you should be put to rest for good, say health officials. They are increasingly recognizing that control of pain leads to more rapid recovery for hospitalized patients, and can even cut costs. Read More

November 28, 2006
National Expert from Utah Spearheads Educational Campaign: FDA Issues Methadone Warning: Providing Safe Access to Pain Medications. SALT LAKE CITY, Utah – November 28, 2006 – The Food and Drug Administration issued a warning yesterday to healthcare profe Read More

October 24, 2006
Prescription Medication Deaths Are On The Rise: Six Steps You Should Know: National Expert Calls for "Zero Unintentional Deaths" with Brigham City Physicians  SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled Read More

October 18, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: National Education Campaign Comes to Brigham City Community Physicians. SALT LAKE CITY, Utah – October 18, 2006 – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Directo Read More

October 18, 2006
National Expert Calls for Zero Unintentional Deaths: National Expert Calls for "Zero Unintentional Deaths" with Hawaiian Physicians SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled “Zero Unintentional Overdose D Read More

September 27, 2006
Methadone Related Deaths On The Rise : Six Steps You Should Know SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announces six steps to avoid acci Read More

September 20, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: Statewide Education Campaign Goes National SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announced that h Read More

September 18, 2006
Local Pain Medicine Specialist Calls For Zero Unitentional Deaths: National Education Campaign Comes to St. George Community SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, a Read More

June 8, 2006
Dr. Lynn R Webster Kicks Off Statewide Education Campaign: LOCAL PAIN MEDICINE SPECIALIST CALLS FOR ZERO UNINTENTIONAL DEATHS SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® &a Read More

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