Treating pain: When is an opioid the right choice?

Opioid medications are sometimes a reasonable treatment option, when used with significant caution.

By Mayo Clinic Staff

Treating pain: When is an opioid the right choice?

Opioid medications, commonly called narcotics, are derived from the poppy plant. Some opioids are available as prescription medications, regulated as controlled substances by the Drug Enforcement Administration. A doctor must have a special license in order to prescribe these. Other opioids, such as heroin, are illegal under all circumstances and have no legitimate medical purpose.

Long-term use of opioids can lead to physical tolerance, misuse, addiction and unintentional overdose. In recent years, prescription and use of opioid medications has steadily increased. These drugs are currently responsible for the majority of prescription drug-related overdose deaths in the United States.

Still, despite the steep risks associated with opioid misuse — the Centers for Disease Control and Prevention calls the problem an epidemic — these medications remain an important option for their original purpose: managing pain. In certain situations and, generally, for short periods of time, opioids can offer safe and powerful pain relief.

Types of pain for which opioids may be prescribed

Opioid medications are often prescribed for a sudden, acute episode of pain that occurs after surgery or a traumatic injury, such as a broken (fractured) bone. Opioids are used for as short a period of time as possible in such cases — often, just a few days.

In addition, opioids offer an important treatment option for people with cancer-related pain. Studies indicate that up to one-third of cancer patients don't receive adequate pain treatment. People with poorly managed cancer pain are at increased risk of long and repeated hospital stays, of disruptions in their treatment schedule, and of difficulty managing the activities of daily living. Opioid treatment can play an important role in improving the lives of people with cancer.

In very select cases, opioids may also be the right choice for you if you're living with chronic, noncancer pain that hasn't responded well to other pain medications and affects your ability to function. Opioids can lead to long-term medical side effects, including making chronic pain more difficult to control. After a short trial of opioid treatment, your doctor will only continue prescribing these medications if regular checkups show the benefits outweigh the harm in your case.

Expect close follow-up during opioid treatment

Before prescribing an opioid to treat your pain, your doctor will get a detailed medical, family and social history and have you undergo a thorough physical examination. Results can help determine whether opioids are right for you. Your medical history will also help your doctor determine if you should be seen by a mental health provider or addiction specialist while you're using opioids, to reduce the risk of unsafe use. Patients with a prior history of any substance abuse are at significantly increased risk of developing addiction to these medications.

While taking opioids, your doctor will require frequent follow-up visits as well as periodic laboratory tests to monitor you for side effects and potential misuse.

Nov. 02, 2017 See more In-depth

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