What are opioids?

Opioids are a group of medicines that your doctor may prescribe to treat pain.

How do opioids work?

Opioids work by interacting with the opioid receptors in your brain. These receptors help control pain. When opioids attach to these receptors, they interrupt pain signals between your body and brain, which relieves your pain.

Opioids also cause your body to release a chemical called dopamine. Dopamine makes people feel good. This is why opioids can be so addictive.

If you take opioid medicines for long enough, your body 'gets used' to the medicine. This means that you will need to take larger amounts of the opioid to get the same effect (known as 'tolerance'). Larger doses of opioids increase your chance of experiencing harmful side effects.

Long-term use of opioids can increase your chance of dependence. This is when you need the drug or medicine to function normally. Dependence on opioids can still occur even if you take your medicines exactly as prescribed by your doctor.

What types of medicines might I be prescribed?

There are many types of opioid medicines your doctor may prescribe, including:

• buprenorphine
• methadone
• fentanyl
• hydromorphone
• morphine
• oxycodone
• tapentadol
• codeine
• tramadol

Different opioid medicines may be taken in different ways, including:

• tablets or pills
• patches on your skin
• injections
• intravenous infusions

In Australia, you need a prescription from your doctor to buy opioid medicines. You can't buy opioids over-the-counter from a pharmacy. For acute (short-term) pain, your doctor will usually prescribe only enough opioid medicine for you to take while your pain is severe.

Buying or taking opioids without a doctor's prescription is illegal.

What are the side effects of opioids?

If you take opioids, you may experience some of these side effects:

• constipation
• nausea and vomiting
• drowsiness
• dizziness
• itchy skin
• urinary retention

You may also experience some serious side effects that can be life-threatening, such as:

• breathing problems or shallow breathing
• heart complications — slow heart rate and low blood pressure
• confusion, delirium or loss of consciousness
• osteoporosis
• dependence and addiction
• overdose

You have a higher chance of life-threatening breathing problems:

• when you first start taking opioids
• if your dose has been increased
• if you are an older adult
• if you have an existing lung problem

Read more about addiction to medicines.

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

Signs of an opioid overdose include:

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

What is naloxone?

Naloxone treats opioid overdose by temporarily blocking opioid receptors. This temporarily stops opioid drugs from working. Naloxone does not make you feel 'high' and does not cause addiction.

Naloxone can be given as:

• an infusion into a vein
• an injection
• a nasal spray

If someone is suffering an opioid overdose, naloxone can be given by family, friends or bystanders.

If you give naloxone, write down the dose and the time so you can tell emergency medical professionals, such as paramedics, when they arrive.

Naloxone stays in the body for a shorter time than many opioids. Naloxone works for about an hour. Heroin and other opioids can stay in the body for much longer. If you take or give someone naloxone, be aware that the overdose can resume after the naloxone stops working.

Take Home Naloxone program

Naloxone is a medicine that temporarily reverses the effects of an opioid overdose. The Australian Government is offering this medicine free of charge and without a prescription to people who may experience, or witness, an opioid overdose.

Learn more about the Take Home Naloxone program.

Can I drive or operate heavy machinery if I am taking opioids?

Opioids may make it difficult for you to drive or operate heavy machinery. If you have recently started taking an opioid medicine or the dosage has changed, you have a higher chance 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, such as sedatives. If these apply to you, you have a higher chance of side effects from opioid medicines.

Does stopping opioids cause withdrawal symptoms?

If you have been taking an opioid medicine regularly (for more than a few weeks) you may experience temporary withdrawal symptoms if you stop taking them suddenly.

Withdrawal symptoms might feel like a bad flu or stomach bug. They usually peak around 2 to 3 days after you stopped taking opioids and resolve within 5 to 7 days.

If you need to stop your opioid medicine, ask your doctor or pharmacist how to reduce your dose slowly to lower your chance of withdrawal symptoms.

Read more about opioid withdrawal.

How can I take opioids safely?

You should always take medicines as your doctor prescribed them. Do not take a larger dose or use somebody else's medicines.

If you want to stop taking opioid medicines, your doctor can guide you on how to slowly reduce your dose over a few days or weeks. This is known as 'weaning off' or tapering a medicine. This will help to reduce the chance of withdrawal symptoms.

While tapering your medicine, you should see your doctor regularly for review.

Always talk to your doctor or pharmacist before stopping your pain medicine.

Read more about taking opioid medicines safely.

When should I see my doctor?

You should see your doctor if:

• you have been prescribed opioids and they are not helping
• you have side effects from your opioid medicines
• you want help to wean off opioids to reduce your chance of withdrawal symptoms
• you are having trouble managing withdrawal symptoms — your doctor may prescribe other medicines to help manage the symptoms
• you are worried about becoming dependent or addicted to opioids

You should speak to your doctor or pharmacist before taking your opioid with other medicines (prescribed or non-prescribed).

Here are some useful questions you can ask your doctor or pharmacist:

• What type of pain medicines have I been prescribed?
• How and when to start and stop taking these medicines?
• How are opioids expected to help me?
• What side effects might I experience?
• What can I expect if I stop taking my medicines?
• Are there any other options to relieve my pain?

Are there any alternatives to opioids?

Depending on what is causing your pain, there may be many other types of pain medicines to try, including:

• paracetamol
• non-steroidal anti-inflammatories (NSAIDs)
• anticonvulsant medicines
• antidepressant medicines

Talk to your doctor if your medicines are not helping you manage your pain, if you need to frequently increase your dose or if you're experiencing side effects.

Medicines alone are not the most effective way to treat chronic pain.

Learn more about chronic pain and options for managing chronic pain.

Resources and support

• Call the Pain Link Helpline on 1300 340 357 for support and tips from people with personal experience of chronic pain.
• Read more about opioids on the SA Health website.
• Visit painHEALTH for information, personal stories and tips to help with management of musculoskeletal pain.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Languages other than languages

The Alcohol and Drug Foundation has translated their guide to using medicines safely into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Your Room has resources and information about drugs for Aboriginal and/or Torres Strait Islander people.