Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.

beginning of content

Opioids

8-minute read

If a person is not breathing, or if they are unresponsive, seek help straight away. Call triple zero (000) and ask for an ambulance.

Key facts

  • Opioids are pain medicines that must be prescribed by a doctor.
  • Opioids are not generally recommended for long-term use, except in cancer or palliative care patients.
  • Signs of an opioid overdose include vomiting, breathing problems and unresponsiveness.
  • Naloxone, a medicine that temporarily reverses the effects of an overdose, is available to some Australians free of charge as part of a pilot program.

What are opioids?

Opioids are a group of medicines that may be prescribed by a doctor to treat pain. Opioids reduce feelings of pain by interrupting the way nerves signal pain between the brain and the body. Sometimes opioids are taken after being obtained illegally for non-prescribed use.

Opioids work by interacting with the opioid receptors in your brain. This can have several effects, including altering how you feel pain. Opioid-based medicines can be prescribed by your doctor, and may contain regulated active ingredients such as:

These medicines can be taken in different ways, including as tablets or pills, injections or patches on the skin.

What is the difference between opioids and opiates?

There are 2 groups of opioids: those that occur naturally and come from the opium poppy are called opiates — for example, codeine, morphine and heroin — and those that are created synthetically, such as pethidine and fentanyl.

What are the benefits of opioids?

Your doctor might prescribe opioids to:

  • treat acute (short-term) pain, such as pain associated with surgery or a medical procedure
  • treat chronic pain (pain lasting more than 3 months) caused by cancer
  • reduce pain in palliative or end-of-life care
  • be a substitution therapy to reduce harm for people who are opioid-dependent

Evidence shows that opioid medicines are not very useful for managing chronic non-cancer pain — sometimes called persistent pain.

How are opioid medicines obtained?

Before you take opioid medicines, you need to have a prescription from your doctor. You can't buy opioids over the counter from a pharmacy. For acute pain, your doctor is likely to prescribe enough medication for the expected duration of severe pain.

What are the risks in using opioids?

Like all medicines, using opioids comes with possible risks. All opioids can cause life-threatening breathing problems. The risk is higher:

  • when you first start taking opioids
  • after a dosage increase
  • if you are older
  • if you have an existing lung problem

Some of the unwanted effects of opioids may be mild, such as drowsiness, nausea, and constipation.

Others can be serious and may be signs of an overdose. These signs include shallow breathing and being unresponsive or unconscious.

If you, or another person, are experiencing an opioid overdose or a serious side effect, call triple zero (000) immediately and ask for an ambulance.

Opioids may make it difficult for you to drive or operate heavy machinery. If you have recently started taking an opioid medication or the dosage has changed, you may be at higher risk of having an accident.

There are other factors that may limit your use of opioids — for example, if you drink alcohol or take other medicines that can cause drowsiness.

Speak to your doctor or pharmacist before taking your opioid with other medications (prescribed or non-prescribed). Never share your opioids with anyone, or take opioids that have been prescribed for someone else.

Does stopping opioids cause withdrawal symptoms?

If you have been taking an opioid medicine regularly, for more than a couple of weeks, you can experience temporary withdrawal symptoms if you stop them abruptly. Withdrawal symptoms can include:

If you need to discontinue your opioid medication, your doctor will help you reduce the dosage safely and slowly, so you’re less likely to experience withdrawal symptoms. Your doctor will monitor your health during this time.

If you’re having trouble managing withdrawal symptoms, your doctor may prescribe medicines to help manage the symptoms.

How can I avoid becoming addicted to opioids?

Opioids are generally not prescribed for long-term use (except in the management of some cancer pain or other exceptional circumstances). This is because tolerance can occur — this means that you may need to take larger amounts of the opioid to get the same effect. As the dosage increases, so does the risk of harmful side effects.

Long-term use of opioids can put you at risk of being dependent on opioids, which is why it's important to review your medications with your doctor regularly. Dependence on opioids can still occur even if you take your medicines exactly as prescribed by your doctor.

Your doctor may reduce your dosage of opioids over time and introduce other pain management strategies, including exercise and counselling services, or other medicines such as paracetamol. These have been found to help many people manage their pain, while minimising the risks associated with opioid use.

When should I see my doctor?

If you are taking a prescription opioid you should check in with your doctor frequently to make sure that it's still the best treatment option for you.

If you feel that the opioid you were prescribed is not helping with your pain, discuss this with your doctor. They may recommend a different approach to managing your pain and may also help you to gradually stop taking opioid medicines. You should not change the dosage you are taking without speaking to your doctor first.

If you are concerned about becoming dependent on, or addicted to, opioids, see your doctor. They may slowly decrease the amount of opioid you are taking, or enrol you in an opioid substitution treatment program.

How do I know if someone is having an opioid overdose?

If you are concerned that you, or someone you know, may have taken too much of an opioid, call your doctor or the Poisons Information Centre (13 11 26) for advice. If the person is not breathing or is unresponsive, call triple zero (000) and ask for an ambulance immediately.

These signs may indicate an opioid overdose:

  • slow, difficult or shallow breathing
  • vomiting
  • a gurgling or choking sound
  • bluish skin and nails
  • being unresponsive

These signs of overdose are the same whether the opioid was a prescribed medicine or it was obtained or used illegally.

Access to overdose-reversing medication

Naloxone is a medicine that can reverse the effects of an opioid overdose. A pilot program, funded by the Australian Government, is offering certain individuals in New South Wales, South Australia and Western Australia this medication (including the nasal spray Nyxoid), free of charge and without a prescription.

Learn more here about the take home naloxone pilot.

What should I do during an overdose?

Call triple zero (000) and ask for an ambulance, or go to the nearest hospital emergency department. If a person overdoses on opioids, naloxone should be given urgently.

Understanding naloxone

Naloxone treats opioid overdose by temporarily blocking opioid receptors, which prevents the opioid drugs from working. Naloxone doesn’t make people feel ‘high’, doesn’t itself cause addiction and there have been no reported deaths from naloxone overdose.

Naloxone stays in the body for a shorter time than many opioid drugs. While naloxone works for around 1 to 1.5 hours, heroin and other opioid drugs stay in the body for much longer (more than 12 hours for some sustained-release opioids). Care needs to be taken so that the overdose doesn't resume once the naloxone has ceased working.

It’s common for people who have been revived with naloxone to crave more opioids. Taking more opioids after taking naloxone could cause a second overdose and is particularly dangerous.

Naloxone is injected into a muscle or given as an intranasal spray. In the event of an emergency opioid overdose, naloxone can be administered by family, friends or bystanders. Note the dose and the time the naloxone is given so you can tell emergency medical professionals, such as paramedics, when they arrive to assist.

Resources and support

For more information on opioid use and overdose prevention:

  • Talk to your doctor or pharmacist.
  • Learn more about the take home naloxone pilot.
  • Contact the Pharmacy Programs Administrator to find out how to register for the take home naloxone pilot on 1800 951 285 (9am to 8pm AEST, Monday to Friday).
  • For overdose resources, including step-by-step videos, go to the Penington Institute website.
  • For advice on medicines, including opioids and naloxone, call the NPS MedicineWise Medicines Line on 1300 MEDICINE (1300 633 424), 9am to 5pm AEST, Monday to Friday.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: January 2021


Back To Top

Need more information?

These trusted information partners have more on this topic.

Top results

Opioids | SA Health

Information on opioids for clincians, includes treatment options as well as opioid misuse

Read more on SA Health website

Opioids - Alcohol and Drug Foundation

Opioids include any drug that acts on opioid receptors in the brain, and any natural or synthetic drugs that are derived from or related to the opium poppy.

Read more on Alcohol and Drug Foundation website

Opioids information video - NPS MedicineWise

Opioids are a class of medicines taken to help reduce pain

Read more on NPS MedicineWise website

ANZCA | Opioids and chronic pain

Opioids are a class of medicines taken to help reduce pain. They work on the central nervous system to slow down nerve signals between the brain and the body.

Read more on ANZCA – Australian and New Zealand College of Anaesthetists website

Prescription opioids | Therapeutic Goods Administration (TGA)

To minimise the harm caused by opioid prescription medicines to Australians each year, a number of regulatory changes are being implemented. The changes will ensure the safe and effective prescribing and use of opioids while maintaining access for patients who need them.

Read more on TGA – Therapeutic Goods Administration website

Prescription opioids Effects and FAQs | Your Room

Opioids are natural drugs derived from the opium poppy or synthetic drugs, and have a depressant or sedating effect, causing the brain and central nervous system to slow down.

Read more on NSW Health website

Understanding Australia's new opioid overdose rescue treatment | Therapeutic Goods Administration (TGA)

Australian launch of a new product called Nyxoid nasal spray for opioid overdoses

Read more on TGA – Therapeutic Goods Administration website

Opioid medicines and chronic non-cancer pain - NPS MedicineWise

Opioid medicines can be used to reduce some types of pain, such as acute pain and chronic pain caused by cancer. However, they have a limited role in the management of chronic non-cancer pain. Find out more.

Read more on NPS MedicineWise website

Accessing pharmacotherapy (opioid replacement therapy) during COVID-19 - Alcohol and Drug Foundation

Pharmacotherapy, in the form of opioid replacement therapy (ORT), is the replacement of a drug of dependence, such as heroin, codeine and OxyContin, with a legally prescribed substitute.

Read more on Alcohol and Drug Foundation website

Opioids out of balance - NPS MedicineWise

Managing chronic non-cancer pain requires health professionals to balance the benefits and harms of all treatments

Read more on NPS MedicineWise website

Healthdirect 24hr 7 days a week hotline

24 hour health advice you can count on

1800 022 222

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Government of South Australia, health department logo Tasmanian government logo Government of Western Australia, health department logo