Opioid medicines can help alleviate pain. But like all medicines, opioids come with risks and side effects. You should be informed about your pain medication and pain-relief options. Here are some frequently asked questions about opioids.

What is an opioid?

Opioids are a group of prescription pain medicines. 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.

What are the benefits of opioid medicines?

Opioids are strong pain medicines prescribed 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
• substitute another opioid of which a person is dependent, reducing the risk of harm

What are the risks of opioid medicines?

Opioids can cause unwanted side effects, including drowsiness, nausea and constipation. Opioids may make it difficult for you to drive or operate heavy machinery.

Other side effects can be serious and may be signs of an overdose. These include life-threatening breathing problems and being unresponsive or unconscious.

It's important to know if your pain medicine is an opioid and to learn how to use it safely.

What is naloxone?

Naloxone is an overdose-reversing medication that blocks the effect of opioids on the brain and can be used to reverse an overdose of prescription or illegal opioids.

What’s the difference between acute and chronic pain?

Chronic, or ‘persistent’ pain, is pain that lasts for more than 3 months or, in many cases, beyond normal healing time. Acute pain, such as pain from an injury, develops quickly and is usually temporary.

Are opioid medicines effective for chronic pain?

Evidence shows that opioid medicines are not very useful for managing chronic non-cancer pain — sometimes called ‘persistent pain’. This is partly because the longer a person takes an opioid, the less pain relief they will receive. Long-term use of opioids can also make a person more sensitive to pain.

Opioids can be effective treatments for the short-term management of acute pain — for example, after a recent injury or surgery — and for people with cancer pain or who are receiving palliative care.

How do I talk to my doctor about my pain medicines?

Asking questions about your treatment or medicine is important. You have a right to ask your doctor or pharmacist about the medicines you are prescribed. You should also know what to expect if you stop taking, or avoid taking, your medicines.

Can I be pain free?

Pain is a complex condition and everyone experiences it differently. Acute pain, such as from an injury (which develops quickly), usually goes away when the injury has healed. Sometimes pain can last beyond the normal healing time and becomes chronic, or ‘persistent’, pain.

Most people with chronic pain learn to manage it, but it may not go away completely.

What causes chronic pain?

Chronic pain can be caused by illnesses such as migraine, osteoporosis, cancer, arthritis and other musculoskeletal conditions. It can emerge after an injury or surgery. Sometimes there is no apparent cause.

Can I become addicted to my pain medication?

Pain medicines that contain opioids are potentially addictive.

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.

What does 'tolerance' and 'dependence' mean?

Long-term regular use of medicines containing opioids can lead to tolerance or dependence.

Tolerance can occur when medicines are used regularly for prolonged periods of time.

It means that you may need to take larger amounts of the medicine to get the same effect.

Dependence can occur when your body becomes used to you taking a particular medicine. If you stop the medicine abruptly you may experience withdrawal effects.

You can develop physical dependence, psychological dependence or both. Psychological dependence is also known as opioid use disorder, or addiction.

What is 'opioid-use disorder'?

Opioid-use disorder is sometimes called 'addiction'. Symptoms of this can include an over-reliance on your opioid medicine, a loss of control over your use of it and compulsive use of the medicine. People with opioid-use disorder may continue to use opioids even if they’re experiencing harm.

You can develop opioid-use disorder even if you take opioid medicines as prescribed by your doctor. If you find yourself using opioids in higher dosages — for example, to cope with stress or for reasons other than pain — you may be developing a problem with your opioid use.

People experiencing opioid-use disorder often find that using opioids becomes more important than other activities in their life. They may crave opioids and find it very difficult to stop using them. People with an opioid-use disorder are more likely to experience other harms, including opioid overdose.

What’s the difference between opioid-use disorder and physical dependence?

Physical dependence can lead to withdrawal symptoms (or physical cravings) if you stop taking opioids after long-term use. Having a physical opioid dependence does not mean that you have opioid-use disorder, which is a psychological dependence, or an over-reliance, on your opioids.

Withdrawal symptoms after stopping long-term opioid use is expected. You may need some help to reduce your opioids slowly.

Can I stop taking my pain medicines?

There are different types of pain-relief medicine. Whether you can stop yours abruptly will depend on which medicine you take and for how long you have taken it. Some medicines, such as opioid medicines or antidepressants, may require you to have the dosage reduced slowly to prevent withdrawal symptoms.

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

What does ‘weaning off’ or ‘tapering’ medicines mean?

If you’ve been taking certain types of medicine regularly for more than a couple of weeks, you may experience temporary withdrawal symptoms if you stop taking them abruptly. To reduce the likelihood of withdrawal symptoms your doctor may reduce your dosage slowly over several days or weeks. This is known as 'weaning off', or tapering, a medicine.

Tapering of medicines should be done under the supervision of your doctor.

What pain medicines can I take instead of opioids?

There are many types of pain medicine, including: over-the-counter (OTC) medicines such as paracetamol and non-steroidal anti-inflammatories (NSAIDs); other prescription medicines such as anti-epileptic drugs and antidepressants; topical products; and supplements.

You should talk to your doctor if your current medicines are not helping you control your pain, or if you're experiencing side effects.

Are there other ways to manage my chronic pain?

Medicines alone are not the most effective way to treat chronic pain. It’s best managed using a combination of different approaches, which might include pain-relief medicines, but also strategies such as physiotherapy, exercise, relaxation techniques and building stress-management skills.

This leads to more improvements in mood, overall health and ability to function.

Will the recent changes to opioid laws affect my access to pain medicine?

Due to recent legislation, the number of doses of opioid medicines in some packs (initially prescribed to people for short-term pain relief) has been reduced. This is to decrease the risk of harm from unused opioids. Larger pack sizes are still available for people who need them.

If you require opioid treatment for a long period of time, such as if you have cancer or are receiving palliative care, you'll still be able to receive your medication in the same way, with the same pack sizes, as you do now.

If you require opioids for the long-term treatment of chronic non-cancer pain, your doctor will still be able to prescribe your opioid medicines. However, you may be referred to a pain specialist or a different prescriber for a clinical review. Talk to your doctor for more information.

If you’re very worried about how these changes affect you, you can speak to a counsellor, 24 hours a day, by calling Lifeline (13 11 144) or Beyond Blue (1300 22 4636).

Where can I get more information and support? 

• Call 1300 MEDICINE (1300 633 424) from 9am to 5pm AET, Monday to Friday, to talk about your pain medicines.
• Discuss your pain on the Pain Link helpline (1300 340 357), which is staffed by volunteers with personal experience of chronic pain.
• Go to Painaustralia to find pain services and programs in your area.
• Learn more about prescription opioids on Choosing Wisely.
• Go to the Alcohol and Drug Foundation to find alcohol and drug support services in your area.
• Chronic Pain Australia has information for people living with chronic pain.
• painHEALTH offers info, tips and personal stories to help with musculoskeletal pain.
• Visit Palliative Care Australia for support for people with pain during palliative care.
• Learn about opioid dependency and get support at Reach for the facts.
• Go to the Therapeutic Goods Administration (TGA) website for information on prescription opioids.
• Access a free online chronic-pain management course at THIS WAY UP.
• Your Room is an initiative by NSW Health and St Vincent's Alcohol and Drug Information Service — find information on opioid-related harm and support services in NSW.