Opioids: Helpful or harmful?

Imagine this: You’re helping a friend move when suddenly there is a sharp pain in your lower back. The doctor says you have a herniated disc, and you need surgery to correct it. She prescribes hydrocodone to combat post-surgical pain. Two weeks later, you’re still in pain, but the usual dosage does not relieve it. You start taking more hydrocodone than prescribed to achieve the same level of relief.  

Opioids like hydrocodone are sometimes necessary for pain relief, but if they are used for too long, opioids can cause addiction, overdose and even death. Due to misinformation from pharmaceutical companies, physicians overprescribed opioids in the 1990s, resulting in the present opioid crisis—public health’s number one priority.

What is the truth about opioids? Are they helpful or harmful? To better understand this powerful pain reliever and potentially-lethal substance, Live Well Georgia solicited the help of Opioid Compliance Specialist Nicholas Heaghney:

Opioid pros                                                                                                       

  • Opioids used to treat chronic or acute pain are highly effective, and when used as directed by a licensed physician, opioid use is safe. (Only use opioids when prescribed by a licensed physician, and only use opioids as directed by that physician.)    
  • Opioids attach to receptors in the brain, sending signals that block pain, slow breathing and produce a generally calming and anti-depressive effect.   

Opioid cons

  • Patients using opioids over a long period of time can develop a tolerance or dependence on the drugs. Patients whose tolerance increases as the result of opioid use need more of the drug to get the same effect. Patients who are opioid dependent will experience withdrawal symptoms without the drug.
  • It is unsafe to use any opioids without a prescription from a doctor. It is unsafe to use opioids in conjunction with other drugs, especially benzodiazepines (Xanax, Ativan) and alcohol.
  • Seventy-five percent of heroin users report first using a prescription opioid (not necessarily prescribed to them).  
  • Legal and illegal opioids can be abused. Heroin and fentanyl overdoses have been on the rise for much of the past decade, but prescription drug abuse has also seen massive increases during that time as well.  
  • There is evidence that opioid abuse is harmful to the brain and respiratory system. Individuals with an opioid use disorder have a significantly increased risk of overdose. Long-term effects of opioid abuse are still being studied.   
  • Individuals experiencing opioid withdrawal can feel muscle pain, have gastrointestinal issues such as nausea, vomiting and diarrhea, experience restlessness and general anxiety, along with other symptoms.   
  • The national rate of opioid overdoses has been steadily increasing since at least 1999. The biggest increases have occurred in fentanyl and fentanyl analogs with nearly 30,000 overdose deaths in 2017 being attributed to fentanyl and other synthetic opioids.

When used as prescribed, opioids serve the purpose of relieving pain. When they are over-prescribed, or used incorrectly, addiction, overdose and even death can occur. If you are prescribed opioids by your physician, make sure you are clear on directions for use, consider your family history (and choose an alternative pain-reliever if necessary) and store them in a safe place, inaccessible to others.

For information on how to handle opioid overdose, read "Emergency Help for Opioid Overdoses."