Patient Brochure

A Guide to Staying Safe and Preventing Unintentional Death While Taking Pain Medication

You have received a strong pain medication called an opioid (narcotic). Opioids contain narcotics and are great for treating pain. It is good that you are getting treatment for pain rather than suffering needlessly. But opioids can also harm you if you use them the wrong way. The risk of harm goes hand-in-hand with the benefit of pain relief. The good news is these risks can usually be managed.

Please take a moment to read this guide online or download the PDF here. It contains information you need to use your pain medication responsibly. This information could save your life or the life of someone you love.

Possible risks from taking opioids include:

Who is at risk for addiction?

What are some signs of drug abuse and misuse?

Why are teens at a higher risk for abuse of prescription pain relievers?

How can you help prevent death from overdose?

A warning for people who have sleep problems and take opioids.

You should never "play doctor" with opioids.

Help is available if you need more relief.

 

Possible risks from taking opioids include:

  • Addiction
  • Drug abuse
  • Death from overdose
  • Disordered breathing during sleep
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Who is at risk for addiction?

True addiction to prescription opioids is rare. The rate of addiction to all kinds of opiates is only about 1 percent in the general population and less than 4 percent in patients with chronic pain who take opioids.

  Patients who become addicted to opioids will show the following behaviors, known as the 4Cs: 

  • Impaired control over drug use
  • Compulsive use
  • Continued use despite physical, mental or social harm
  • Craving

Most people who take opioids for pain will not become addicted. Those who do will need treatment for addiction. Addicted people are very susceptible to relapse and may return to active abuse even after being clean for some time. People recovering from active addiction may need several rounds of addiction treatment, and it is important not to give up.

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What are some signs of drug abuse and misuse?

So you might ask, if so few people become addicted to opioids, why do so many people seem to be abusing them – or even dying?

Some ways people misuse their medications are by:  

  • Experimenting with them recreationally
  • Sharing prescriptions with others
  • Taking too much medication to try to control pain
  • Mixing prescriptions with substances such as alcohol, recreational street drugs, or other prescriptions, particularly sedating ones such as Valium

Many young people are especially prone to abusing prescription drugs, perhaps as a result of influence from peers or even because the young tend to need high doses of medication to achieve pain relief. Drug abuse does not discriminate, however, and older people are also in danger of misusing their medications, sometimes to mask feelings of depression, anxiety or other problems.

Stress can contribute to abuse. Unrelieved pain causes stress as do the financial worries and family strain that often accompany ongoing pain.

If stress is overwhelming and opioid use is getting out of control, help is available. Your healthcare provider can supply treatment and coping strategies or refer you to someone who can help.

Any type of opioid misuse can be deadly. Each of us must respect the power of these pain medicines and teach our children to do the same.  Just because they have come from a doctor’s office does not make them “safe” when misused.

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Why are teens at a higher risk for abuse of prescription pain relievers?

According to the Partnership Attitude Tracking Survey (PATS)*, teens in grades 7 through 12 hold the following attitudes: 

  • About half of all teens do not see great risk in abusing prescription drugs
  • A majority of teens agree prescription drugs are easier to get than illegal drugs
  • Fourof 10 believe they are much safer to use than illegal drugs – even if they weren’t prescribed by a doctor
  • Roughly three of 10 agree there is nothing wrong with using prescription medicines once in a while and that prescription pain relievers are not addictive

Such surveys show that many teens hold dangerous views about prescription drugs. Furthermore, research shows that most teens obtain the drugs they abuse from family and friends – often stealing prescriptions from a medicine cabinet. It is important to talk to teens about drug abuse and to safeguard your own prescriptions to ensure they are not accessible to teenagers or others who visit your home.

*Completed in 2005 by 7,218 adolescents.

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How can you help prevent death from overdose?

If you or a family member is on long-term opioid therapy, be sure everyone in your household knows the danger signs of respiratory depression. Summon medical help immediately if a person demonstrates any of the following signs while on opioids:

  • Snores heavily and cannot be awakened
  • Has trouble breathing
  • Exhibits extreme drowsiness and slow breathing
  • Has slow, shallow breathing with little chest movement
  • Has a speeded up or slowed heartbeat
  • Feels faint, very dizzy, confused or has heart palpitations.
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A warning for people who have sleep problems and take opioids.

Sleep apnea is a condition where breathing temporarily stops. It has been observed in up to 75 percent of patients who take opioids long term for chronic pain. Methadone is one opioid tied to sleep apnea in recent research, but other opioids have shown similar effects. When tranquilizers are added, the risk is heightened with some opioids. So far, we have no evidence patients who take opioids short term – such as after a surgery – are at risk. More research is needed, but for now it pays to take a few precautions.

Talk to your doctor if you are being considered for long-term opioid therapy and have been diagnosed with sleep apnea, or have risk factors for sleep apnea such as being overweight or taking a very high opioid dose. Screening methods and treatments for sleep apnea are available.

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You should never "play doctor" with opioids.

Never adjust your own doses. Take these medications only as directed and never mix them alcohol or with other sedating substances unless directed by your prescribing physician. Always tell your healthcare provider about all medications you are taking from any source. Keep track of when you take all medications, enlisting the help of others if necessary.

Even when the pain relief from an opioid has worn off, the depressant effect on breathing may continue. This is true for all opioids but particularly true for methadone, which lingers in the body longer than many medications.

It is important to have realistic expectations concerning opioid therapy. A misconception some patients have is that if they are taking opioids, they should experience no pain at all. Opioids provide good pain relief for many short-term and chronic conditions but cannot always be expected to completely remove all pain. Popping more pills than prescribed to try to relieve all pain is dangerous and counterproductive.

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Help is available if you need more relief.

If you need more pain relief or suffer from additional symptoms such as insomnia or depression, tell your prescribing clinician. Treatments are available, but a healthcare professional must always supervise the addition of medications, dose adjustments or medication changes.

If opioid use is relieving most of your pain, helping you to live and work more productively and coincides with improved mood and quality of life, it is probably the right treatment. If opioid use is causing your life to spiral out of control, and you are losing function and quality of life, it is probably doing you more harm than good. Know that alternatives are available to treat pain if opioids turn out to be the wrong treatment for you or someone you love.

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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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