Opioids

About

Opioids are strong pain-relief medications that work by acting on receptors in the body to change how pain is felt.

There are different types of opioids, which vary in how powerful they are and how they are used.

Examples of less potent opioids are: tramadol (Tramal) and codeine. Codeine is found in medicines such as Panadeine, Panadeine Forte, Nurofen Plus and Mersyndol Forte.

More potent opioids include: morphine (MS Contin, Kapanol, Sevredol), oxycodone (Endone, Oxycontin, Targin), fentanyl (Durogesic), buprenorphine (Norspan), pethidine, hydromorphone (Dilaudid, Jurnista), tapentadol (Palexia) and methadone (Physeptone).

Opioids come in short acting and long acting (sustained release) formulations. They come in tablet, liquid and patch form.

Considerations

Like all medications, opioids can cause side effects. Some are mild, but others can be serious.

Common side effects include: constipation, nausea, vomiting and sedation. There are also more serious risks, such as slowed or shallow breathing and overdose. It's important to discuss these risks with your doctor before starting an opioid.

Long term use of opioids can result in tolerance to the medication (the medication stops being as effective over time). You can also become dependent, which means your body relies on the medicine, and you may have withdrawal symptoms if you stop suddenly. There is also a risk of addiction, especially with long-term use.

Opioids and Osteoarthritis

Opioids are not usually recommended for long-term use in conditions like osteoarthritis or chronic non-cancer pain. Non-pharmacologic interventions (exercise, weight management, healthy sleep, pacing, education) and non-opioid medications (NSAIDs, paracetamol, topical agents etc) are first-line in osteoarthritis and should be optimized before considering opioids. However, opioids may be considered if:

• Your pain is moderate to severe
• Other treatments haven’t worked
• You’re not suitable for surgery

Important Advice

• Opioids should always be started as a trial, with clear goals in mind.
• The medication should be stopped if it doesn’t help or causes side effects.
• Never share opioid medicines with others.
• Always follow your doctor’s instructions.

If you have questions or concerns, talk to your healthcare provider.
Further information: Arthritis Australia - Freedom from arthritis