What makes opioid medications so dangerous?

Answer From Carrie Krieger, Pharm.D.

When used as directed by your doctor, opioid medications safely help control acute pain, such as pain you experience after surgery. There are risks, though, when the medications are used incorrectly.

What opioid medications do

Opioids are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells. Opioids can be made from the poppy plant — for example, morphine (Kadian, Ms Contin, others) — or synthesized in a laboratory — for example, fentanyl (Actiq, Duragesic, others).

When opioid medications travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure.

When opioid medications are dangerous

What makes opioid medications effective for treating pain can also make them dangerous.

At lower doses, opioids may make you feel sleepy, but higher doses can slow your breathing and heart rate, which can lead to death. And the feelings of pleasure that result from taking an opioid can make you want to continue experiencing those feelings, which may lead to addiction.

You can reduce your risk of dangerous side effects by following your doctor's instructions carefully and taking your medication exactly as prescribed. Make sure your doctor knows all of the other medications and supplements you're taking.


Carrie Krieger, Pharm.D.

Vivien Williams: This can be a common scenario: raiding the medicine cabinet for leftover painkillers after a sprained ankle or toothache. There's nothing wrong with popping an occasional opioid, right?

Mike Hooten, M.D. (Anesthesiology, Mayo Clinic): They are dangerous. They could have adverse effects that the individual doesn't even know about.

Vivien Williams: Including addiction or accidental overdose. So, when is it appropriate to take opioids?

Mike Hooten, M.D.: After an operation, opioids are highly effective.

Vivien Williams: Dr. Mike Hooten is a pain management specialist at Mayo Clinic.

Mike Hooten, M.D: After trauma, for example, severe trauma, opioids would be appropriate.

Vivien Williams: Dr. Hooten says opioids are also beneficial during procedures, such as colonoscopies. Problems happen when people take them without a prescription or for too long.

Mike Hooten, M.D.: If they are predisposed to develop addiction, either neurobiologically or from a behavioral perspective, then all of a sudden we are selecting the individuals who may go on to have long-term problems.

Vivien Williams: If you have pain, talk to your health care provider. For the Mayo Clinic News Network, I'm Vivien Williams.

Vivien Williams: Fentanyl is a powerful painkiller.

Mike Hooten, M.D. (Anethesiology, Mayo Clinic): It is many, many times more potent than morphine, oxycodone, oxycontin, Vicadin, dilaudid, hydromorphine, all these types of drugs.

Vivien Williams: Mayo Clinic pain management specialist Dr. Mike Hooten says fentanyl is used in operating rooms, and to control pain after surgery. It also alleviates pain for advanced cancer patients.

Mike Hooten, M.D.: The use of fentanyl for chronic pain, I think, is avoided by many thoughtful practitioners for a number of reasons. Number one, it's high potency.

Vivien Williams: Number two, fentanyl, which is delivered via IV, a patch or in a lozenge, can be dangerous if used inappropriately.

Mike Hooten, M.D.: The reason for that is the sedative effects.

Vivien Williams: If you take too much, combine it with certain other medications, or drink alcohol …

Mike Hooten, M.D.: It clearly can compromise respiratory function, and that is really the start of the accidental overdose cascade.

Vivien Williams: For the Mayo Clinic News Network, I'm Vivien Williams.

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March 21, 2018 See more Expert Answers

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