Opioids Overview

What Are Opioids?

Opioids are a class of medications that work on opioid receptors in the brain to reduce pain perception. They're powerful pain relievers but carry significant risks including dependence, tolerance, and overdose. Their role in chronic pain is increasingly limited.¹

Types of Opioids²

Short-Acting

• Codeine
• Tramadol
• Hydrocodone (Vicodin)
• Oxycodone immediate-release
• Morphine immediate-release

Long-Acting

• Extended-release morphine
• Extended-release oxycodone
• Fentanyl patches
• Methadone
• Buprenorphine

When Opioids May Be Considered

• Severe acute pain
• Cancer pain
• End-of-life care
• Select chronic pain patients (after other options)
• When benefits outweigh risks

Risks³

• Physical dependence
• Tolerance (needing more for same effect)
• Opioid use disorder (addiction)
• Overdose and death
• Constipation
• Sedation
• Hormonal effects
• Hyperalgesia (increased pain sensitivity)

Safe Use Practices

• Take exactly as prescribed
• Never share medications
• Store securely
• Dispose of unused medication properly
• Avoid alcohol
• Know signs of overdose
• Consider naloxone (Narcan) availability

Current Guidelines

CDC guidelines recommend non-opioid therapies as first-line treatment for chronic pain, with opioids considered only when other treatments are inadequate.

References

1. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain. MMWR Recomm Rep. 2016;65(1):1-49.
2. Chou R, Turner JA, Devine EB, et al. The effectiveness and risks of long-term opioid therapy for chronic pain. Ann Intern Med. 2015;162(4):276-286.
3. Volkow ND, McLellan AT. Opioid abuse in chronic pain — misconceptions and mitigation strategies. N Engl J Med. 2016;374(13):1253-1263.