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Safe use of opioid pain medicine after surgery / trauma

Information for patients and families

Introduction

You have been prescribed an opioid pain medicine that is also known as a narcotic. This guide reviews some important safety information about opioids.

Patients, family, friends, and caregivers can play an important role in the safe use of these medicines. Share this information with them.

Click each section below to read more, or download a PDF version of this guide

» Opioids and your pain control

When you take opioid medication there is a balance between pain control and harmful side effects. This is why it is important to make sure you take the medication as directed.

Pain management is important to your wellbeing. Opioids will lower your pain and help you do your day to day activities with less pain. They will NOT lower your pain to zero.

Be sure that you understand your plan for pain control and work closely with your doctor if you need opioids for more than 1 to 2 weeks.

A balanced scale with pain control on one side and harmful side effects on the other

» What are the possible risks of taking opioids?

  • Many people use opioids without problems. However, there are risks of serious problems, including overdose (taking too much) and addiction.
  • It is important to follow the instructions on the prescription. Use the lowest possible dose for the shortest possible time. Be aware of signs (listed on next page) that you are getting too much opioid.
  • Because opioids make you sleepy, avoid alcohol and sedatives such as sleeping pills.

» What are the common side effects?

  • Feeling tired or sleepy
  • Constipation
  • Nausea
  • Dry mouth
  • Itchiness
  • Sweating
  • Dizziness

You should not drive or operate machinery while taking opioids.

» Remember, it’s important to:

  • Never share your opioid medicine with anyone else.
  • Store your opioid medicine in a safe place; out of reach and out of sight of children, teens and pets.
  • Get rid of your opioids as soon as you don’t need them anymore. Do not throw them in the toilet or throw them out in the garbage. Take unused medicine back to a pharmacy for safe disposal.
    • The Sunnybrook Ambulatory pharmacy on M1 in the main lobby will accept your unused medicine.
    • For other locations that accept returns: 1-844-535-8889 or visit healthsteward.ca

» What are the signs of overdose? 

Stop taking the drug and get immediate medical help if you feel the following:

  • Severe dizziness
  • Inability to stay awake
  • Hallucinations, such as seeing or hearing things which are not there
  • Heavy or unusual snoring
  • Shallow or slow breathing rate

Your family member or caregiver needs to call 911 right away if:

  • You can’t speak clearly when you wake up
  • You can’t be woken up
  • Your lips or fingernails are blue or purple
  • You are making unusual heavy snoring, gasping, gurgling or snorting sounds while sleeping

» Pain management guide

How intense is my pain? What can I take to feel better?
  • I hardly notice my pain, and it does not get in the way of my activities.
  • I notice my pain and it distracts me, but I can still do activities (sitting up, walking, standing).

Non-medication therapies

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Non-opioid, oral medications
You may take these to control mild to moderate pain when needed

  • My pain is hard to ignore and is more noticeable even when I rest.
  • My pain interferes with my usual activities.

Non-medication therapies

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Non-opioid, oral medications
You may be told to take them regularly, around the clock

  • I am focused on my pain, and I am not doing my daily activities.
  • I am groaning in pain, and I cannot sleep. I am unable to do anything.
  • My pain is as bad as it could be, and nothing else matters.

Non-medication therapies

+

Around-the-clock non-opioid medications

+

Short-acting opioids (for a few days)
Call your surgeon if your pain continues

American College of Surgeons: facs.org/safepaincontrol

» What are the most common pain control therapies and medications?

Mild pain

Non-medication therapies
Therapy Description
Self-care Ice, elevation, and rest
Complementary therapies Meditation, acupuncture, massage, and music
Rehabilitation therapies Occupational and physical therapy
Exercise Stretching, walking and mild exercise

Mild to moderate pain

Non-opioid, oral medications
Medication Common side effects
Acetaminophen (Tylenol*):
Decreases pain and fever
Nausea, vomiting, headache, and insomnia
Liver damage may occur if you take more than the recommended dose

Non-steroidal anti-inflammatory drugs (NSAIDs): Decrease swelling and fever

• Naproxen (Aleve)
• Aspirin (ASA)
• Celecoxib (Celebrex)
• Ibuprofen (Advil, Motrin)

Upset stomach: Stomach bleeding or ulcers, heart attack, and stroke

Nerve pain medications:
Reduce burning and tingling pain from sensitive nerves

• Gabapentin
• Pregabalin

Dizziness, drowsiness, swelling in the hands and feet, weight gain, and blurred vision

Muscle relaxants:
Reduce pain related to muscle spasm or injury

• Robaxin (methocarbamol)

Lightheadedness, dizziness, drowsiness and mild nausea

Severe pain

Opioids
Medication Common side effects**
Opioids:
Hydromorphone (Dilaudid)
Morphine
Oxycodone

Dizziness, nausea (very common), headache, drowsiness, vomiting, dry mouth, itching, respiratory depression or very slow breathing, and constipation

To prevent constipation, stool softeners or laxatives may be prescribed. Eating a high fiber diet, drinking lots of fluids and exercising daily may also help.

Serious risks include misuse, abuse, addiction, overdose (taking too much of the medication), and death from suppressed breathing

American College of Surgeons: facs.org/safepaincontrol
**Side effects reported in 3% or more of the patients in the study sample