The Valley Doctor | Opioids

There's been much in the news recently about opioid addiction. The use and abuse of opioids has skyrocketed in recent years and has become a truly nationwide problem. The most common opioids are Vicodin (hydrocodone), OxyContin (oxycodone), Dilaudid (hydromorphone) and Demerol (Meperidine).

Opioids are used to reduce pain, especially when over the counter pain medications, such as Tylenol or Advil are not strong enough. Opioids are powerful pain killers that block messages of pain to the brain and decrease the brains perception of painful discomfort. The problem is that they also cause a feeling of euphoria. Opioids are great for short term pain management, such as after an injury or surgery. Opioids are also useful for long term pain such as from cancer. For long term pain other than cancer, their benefit is debatable, especially since taking opioids for 4 weeks or longer puts one at risk for dependence and addiction.

Side effects of opioid use include nausea, constipation, itching, and drowsiness. Stopping opioids after more than short term use can cause withdrawal symptoms such as nausea, vomiting, depression and diarrhea.

The problem is that some 50,000 Americans fatally overdosed on opioid pain medication as of 2017. Every year more people die from opioid drug overdoses than from motor vehicle accidents.

The other problem we're experiencing at an alarming rate today is the use of heroin for those who started their addiction on opioids. Some one million people a year use heroin. The reason for this seems to be that heroin is cheaper and more readily available than are opioids.

Don't be alarmed if your doctor prescribes an opioid. More than 95% of patients won't have a problem taking opioids. One area of concern is teenagers who are prescribed opioids after painful dental procedures especially wisdom tooth extraction. Studies have shown that teens treated with opioids after wisdom tooth extraction have a significantly higher chance of later opioid abuse. Discuss this with your dentist and monitor your child's use of opioids.

Don't try to decrease your addiction risk by cutting down on your dose and waiting until the pain gets so bad that you have to take the medicine. This can actually increase the risk of addiction.

Here are suggestions to keep in mind when taking opioids from your doctor:

* If necessary, have a family member help you to make sure you're taking only the prescribed dose.

* Keep opioids in a lockbox to help prevent them from getting into the wrong hands.

* Keep expectations realistic, total pain relief is rare even with opioids.

* Avoid alcohol or other sedatives while on opioids.

* Safely discard opioids when they are no longer needed or have expired.

Opioids are appropriately recommended mostly for short term and occasionally long-term pain relief. Work closely with your doctor to obtain the most effective and safest use of opioids.

Terry Hollenbeck, M.D., is a retired urgent care physican at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view previous columns on his website,, or e-mail

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