Taking Prescription Opioids?: What to Know About Naloxone

This article is for people who are taking prescription opioids for pain, or their care partners, or anyone who wants to learn more about naloxone and prescription opioids. The goal of this patient education activity is to increase knowledge of patients and care partners about naloxone if prescription opioids are part of their treatment plan for pain.

You will learn about:

• Prescription opioids and their potential risks

• How a prescription opioid overdose can happen and what to do

• What naloxone is and what to know about using it

• How and where to get naloxone

• Questions to ask your doctor

Prescription opioids -- sometimes called opioid analgesics or narcotics -- are medicines that may be used to treat some types of moderate to severe pain. They work in the brain and the body to block pain signals.

Types include:

• Natural, such as morphine and codeine, found in plants

• Semi-synthetic made from natural opioids, including hydrocodone, hydromorphone, oxycodone, and oxymorphone

• Fully synthetic, or manmade, including fentanyl, levorphanol, methadone, and tramadol

Prescription opioids can have side effects including:

• Slowed or restricted (limited) breathing

• Sleepiness or drowsiness

• Dizziness

• Confusion

• Depression

• Being more sensitive to pain

• Constipation

• Nausea and vomiting

• Dry mouth

• Itching

• Sweating

• Lower sex drive, energy, and strength due to low testosterone levels  

• Tolerance -- the need for more opioids to get the same pain relief

• Physical dependence -- problems (withdrawal symptoms) when cutting back or stopping opioids

Prescription opioids can be dangerous if abused or taken differently than prescribed, and may even be addictive. Anyone can get addicted to prescription opioids.

Taking too much opioids can cause an overdose. When opioids overwhelm the brain, they interfere with the signals telling the body to breathe. And because prescription opioids can already slow your breathing, an overdose can stop it all together causing brain damage and even death.

All risks and side effects of prescription opioids are not listed in this activity. Be sure to ask your doctor for a complete list.

Prescription opioids need to be used carefully. Not all overdoses lead to death -- and most are accidental -- but anyone who takes opioids can have an overdose.

The risk of slowed or stopped breathing increases if you've never taken opioids before or you take other medicines that interact with opioids.

Other factors that may increase your risk include:

• Taking high daily doses or more than prescribed

• Using illegal opioids, such as heroin

• Alcohol use

• Age over 65

• Having certain medical conditions, such as sleep apnea or lowered kidney or liver function

Knowing the signs of a possible prescription opioid overdose is important. Acting fast can save a life.

Signs include:

• Slow and shallow (short inhaling and exhaling) breathing

• Choking or gurgling

• Pale, blue, or cold skin

• Small, "pinpoint" pupils

• Falling asleep or losing consciousness

• Limp body

To help someone who's having a prescription opioid overdose:

• Call 911 for emergency help right away

• Give naloxone, if available

• Try to keep them breathing and awake

• Lay them on their side to prevent choking

• Stay until emergency help arrives

Tell doctors or emergency medical workers what kind and how much prescription opioids, other medicines, or drugs or alcohol the person took.

It may be hard to tell if someone is having an overdose. If you aren't sure, it's best to treat it like an overdose.

Naloxone is a medicine that can quickly reverse the effects of a prescription opioid overdose. It's a non-addictive opioid antagonist that blocks opioids and can bring back normal breathing. Naloxone can be life-saving, if given in time.

Naloxone comes in a prefilled device that can be used by anybody -- not just doctors or medical workers -- to help during an overdose.

Anyone using naloxone should carefully read the package insert that comes with it.

Naloxone only has a noticeable effect on someone who already has opioids in their body. It may cause withdrawal symptoms that can be uncomfortable, but aren't life-threatening. These can include body aches, blood pressure changes, fast heartbeat, sweating, nausea, vomiting, and tremors (shaking).

People should be watched closely until emergency help arrives after being given naloxone.

If prescription opioids are part of your treatment plan for pain, it can be helpful to ask your doctor about naloxone. And depending on what state you live in, it may even be required that naloxone be recommended or prescribed for you.

If you're taking prescription opioids, having naloxone on hand can be important for you and those around you, including your friends, family, and those in your home. 

Naloxone is a prescription medicine, but you may be able to get it in the pharmacy without a prescription, depending on where you live. To learn about the regulations for naloxone in your state, talk to your doctor or pharmacist or visit the Prescription Drug Abuse Policy System website at the end of this activity.

Questions you can ask your doctor about prescription opioids and naloxone can include:

• What should I know about taking prescription opioids?

• Should naloxone be part of my pain treatment plan?

• What are the signs of a prescription opioid overdose, and what should I do if it happens?

• Where can I get naloxone and do I need a prescription?

• How do I use naloxone?

Congratulations!

You have successfully completed the program Taking Prescription Opioids?: What to Know About Naloxone

View Additional Materials on this topic that you may find useful:

Save a Life From Prescription Opioid Overdose

Opioids FAQs

If You Are Prescribed Opioids

US Surgeon General's Advisory on Naloxone and Opioid Overdose

Prescription Drug Abuse Policy System