DISCUSSING treatment options with your health care provider and being an informed consumer is the first step. You are in charge of your healthcare. Prescription opioids (such as hydrocodone, oxycodone, codeine, and morphine) are not right for everyone. They can have some very serious side effects. It’s OK to ask your doctor, dentist, or other health care provider for more information about their recommendations before deciding which is the right choice for you or your loved one.
What should I ask? Starting the discussion...
You can start the discussion by asking questions, such as:
- What medications are you considering giving me?
- Is it an opioid?
- Why do you think this is the best course of treatment?
The two most serious risks with an opioid prescription are overdose and addiction. In addition to those very serious risks, prescription opioids can have a number of side effects longer-term, even when taken as directed. These include tolerance (needing to take more of a medication for the same pain relief) and physical dependence (having symptoms of withdrawal when the medication is stopped). Other side effects may include increased sensitivity to pain, constipation, nausea, sleepiness, confusion, and depression.
You can start a discussion with your doctor with these kinds of questions:
- How will I know if I am building a tolerance or dependence to this prescription?
- What should I do if I think I am having a side effect?
- How often should I check in with you about this prescription?
- Will I have any withdrawal issues when this prescription runs out?
You can have a discussion with your doctor about ways to manage your pain that don’t involve prescription opioids. Some of these options may actually work as well or better (but have their own side effects so discuss with your medical professional).
Options you can discuss include:
- Acetaminophen (Tylenol) or ibuprofen (Advil)
- Medications traditionally prescribed for depression or seizures
- Interventional therapy
- Cognitive behavioral therapy
- Physical therapy and exercise
Ask that your doctor prescribe the lowest dose and the smallest quantity you may need and find out when to call to follow up on how well it is working. Find out when and how to stop taking opioids, including tapering them.
Some questions you can ask are:
- Is it OK to stop taking these before the prescription runs out?
- How will I know if it is OK to stop taking this prescription?
- What should I watch for if I stop taking this prescription early?
- How should I taper my usage to make sure I don't have any withdrawal issues?
Tell your doctor about any history you have had with substance misuse or addiction to alcohol or other drugs, or if you have a history of smoking cigarettes. You should also tell your health care provider if anyone in your family has had a problem with substance misuse or addiction.
Some ways to start this discussion include:
- This is a little uncomfortable, but will this prescription be OK if I have my daily drink?
- How will vaping or smoking react with this prescription?
- Sometimes my friends and I use [fill in the drug] on the weekends, how will that react with this prescription?
- I have family members with some addiction problems, am I OK to take this prescription? What do I need to watch out for?
If your doctor thinks your pain is best managed with a prescription opioid, then ask:
It is also very important that you tell your doctor about all of the medicines you are taking, especially those prescribed to treat anxiety, sleeping problems, or seizure. Even medicines you take only occasionally, or that are over-the-counter, could interact with the opioid pain medicine. Don't count on your doctor to know what medications you are taking, even if they prescribed them to you.
Some good ways to start this discussion are:
- Write down all of your prescriptions (including dosage and duration) and bring the list along.
- Take a photo of your medication bottle labels and bring them along.
- Write down any dietary supplements you take, or bring photos of the packaging.
- Write down any over-the-counter medications you take or bring photos of the packaging.
There are both federal and state laws that make using or sharing your prescription drugs illegal. If you a take a pill that was prescribed to someone else or give that pill to another person, not only is it against the law, it's extremely dangerous. Doctors write specific prescriptions to remedy your specific condition. A pain killer prescription for your knee surgery is not going to be the same prescription your daughter would get for a jammed finger or toothache. You are not a doctor. DO NOT GIVE OTHER PEOPLE YOUR PRESCRIPTIONS!
Take your medicine exactly as prescribed by your doctor. If you are still feeling pain, call your doctor; do not take an extra dose. Learn to identify serious side effects so you and your family will know when to call a doctor or go to the hospital. Ask your pharmacist if your prescription comes with a Medication Guide (paper handouts that come with many prescription medicines) for more information.
Good questions to ask include:
- How will I know if I am having a side effect from this prescription?
- What should I do if I think I am having a bad reaction?
- What should I do if I don't feel like the prescription is working?
- Is there anything I can do to make sure I don't get any of the side effects?
SECURE your medications. Consider a lockbox for your medications. Even one accidental dose of an opioid pain medicine meant for an adult can cause a fatal overdose in a child or anyone not used to taking this type of medication. Anyone (including teenagers) in the home or friends who are visiting may seek out opioid pain medicines for nonmedical use. This is actually one of the most common sources of opioid supply for abusers. Don’t leave prescription opioids in the medicine cabinet or out in plain view. Learn more here about SECURING.
Your leftover opioids can be taken by people you’d never expect to take them: friends, relatives, and even your kids and their friends. Proper disposal is the only guarantee that none of your leftover opioids will be misused, or lead to an overdose.
DISPOSE of your unused medications when the reason you were prescribed them is no longer relevant. It’s important to get rid of all those partially-used prescriptions that so many of us have laying around. Holding on to that prescription “just in case” you need it again one day is not a good idea: any accident or impaired driving charge that occurs while under the influence of drugs taken not as prescribed or taken outside the prescribed period can lead to enhanced charges, including charges of possession of controlled substances because, technically speaking, those medications are illegal.
See our DISPOSE section for advice on simple steps you can take to get rid of your unused medications.
When you go to see your doctor:
Write your questions down or have them handy on your phone so that you can take with you into the doctor's office. If possible, bring along a friend or family member who can jot down notes, listen to the discussion, or ask questions.
Take control. You are in charge of your healthcare.