Using opioids in the community
In the community (eg general practice, residential aged care) oral opioid dosages should be conservative (ie not exceed the dosage regimens for moderate, acute nociceptive pain) to ensure safe administration. Subcutaneous opioids should be reserved for emergency situations, and intravenous and intranasal opioids should never be used. Conservative dosages and oral administration reduce the risk of opioid-related harm (eg opioid-induced ventilatory impairment).
When prescribing an oral opioid, always specify the anticipated duration of use in addition to the quantity of opioid to be dispensed. Dispensing excessive quantities of opioid can result in unused opioids in the home, which could lead to misuse. Before prescribing an opioid, it is essential that the patient and anyone involved in their care understands the safe use of opioids. How to use an opioid for acute pain at home outlines key educational points for patients prescribed opioids; it can be printed as a patient information sheet.
What is an opioid?
An opioid is a medicine that acts on the nervous system to reduce pain—it will not take the pain away completely.
Opioids should only be used short term while your body heals. Do not use opioids long term because they can cause significant adverse effects and can be addictive.
How to take your opioid
Your doctor has prescribed an opioid for you to take if required. Only take the opioid if you have pain. Do not take your opioid more frequently than your doctor has prescribed.
Always make sure you have taken your other prescribed pain relief medicines (eg paracetamol, an anti-inflammatory drug).
If your pain is not well-controlled, you might need to change the dose slightly—your doctor will tell you how to do this safely. If your pain is not well-controlled despite adjusting the dose according to your doctor’s instructions, seek medical advice.
As your body heals, reduce the frequency or dose of the opioid until you can stop it completely. Continue taking your other prescribed pain relief medicines (eg paracetamol, an anti-inflammatory drug) until your doctor tells you to stop.
Things to watch out for while you are taking an opioid
Sleepiness—if you become very sleepy or are struggling to stay awake, immediately seek medical attention. Do not take any more opioid doses, even if you still have pain.
Because opioids can make you sleepy:
- avoid driving or operating machinery
- avoid taking other medicines or substances that can make you sleepy (eg alcohol, sleeping tablets, cannabis).
Children who are taking an opioid must be supervised, especially when they are restrained in a car seat, or in a bath.
Safe storage and disposal—store your opioid in a safe place, out of reach of children. Never share your opioid with anyone else. If your opioid is ingested by someone else, seek emergency medical care. Take any leftover opioids to the pharmacy for safe disposal.
Adverse effects—adverse effects caused by opioids are common, but can usually be managed effectively. Keep up your fluid and fibre intake to help prevent constipation; your doctor or pharmacist might recommend a laxative. Contact your doctor if you develop nausea, vomiting or a rash.