Are Opioids Always Bad?

Every day, 40 people die in the U.S. as a result of prescription drug overdose, according to the Centers for Disease Control and Prevention. Media outlets, schools, and the medical community are starting to get the word out – to the degree that more and more people are shying away from opioids completely.

That could be its own problem.

Pain experts still say that opioid painkillers such as Oxycontin, Percocet and Vicoprofen are still the best solution for short-term treatment of pain. This is especially the case right after surgery.

"You have to individualize care," Dr. Edward Michna, an anesthesiologist and pain specialist at Brigham and Women's Hospital in Boston, told Healthline. "Obviously you're not going to torture people when the severity of their pain is such that they should be treated with an opioid. The question is, should that be maintained for a long-term period? That can be debated."

The usual rule of thumb has been that three days of prescribed opioid use is the max. That's because dependency begins within 72 hours, and prescription for longer than that risks addiction. But the CDC has exempted active cancer patients or those who need palliative care at the end of their lives from this guideline.

But, all that said, an opioid overdose can still occur even if patients are taking their recommended dose. Illnesses such as kidney disease or an interaction with another drug may still result in an overdose. Adding to the not-one-size-fits-all confusion is the fact that opioids become less effective over time as the body builds up an immunity.

The American Association of Anesthesiologists recommends that all patients who are prescribed opioids ask themselves three questions:

• Why was I prescribed opioids? Did the doctor assume opioids are the strongest and most effective pain relief for my pain, without considering other options?
• How long should I take prescription painkillers? If you continue to have pain after a few days on an opioid, you should ask your doctor about alternatives.
• Are opioids affecting my quality of life? Using prescription opioids can affect a person in many different ways, including mental fogginess, severe constipation, nausea or depression.

If you find yourself taking painkillers in larger doses or more frequently than prescribed; to ease anxiety instead of relieving physical pain; or if people close to you complain that you seem sedated, sleepy, or not functioning properly, consider yourself “red flagged” for opioid addiction.

The Bottom Line: Opioids are a valuable weapon in your war on pain, but check in with your doctor frequently while prescribed. In a pinch, he is even able to prescribe naloxone, a drug that can reverse an overdose if injected quickly enough.