Opioids and Your Medications Can Be a Bad Mix


Opioids are potent painkillers. And that can be a blessing or a curse.

If you’re in severe pain after surgery or an injury, opioids like morphine, fentanyl, hydrocodone or oxycodone are a godsend. But become dependent on them, and the consequences can be deadly.

“Unfortunately, anyone can develop an opioid addiction — even those who’ve never been addicted to anything in the past,” warns pharmacist Elizabeth Casserly, PharmD, RPh, BCPS. She specializes in pain management.

Opioids are typically safe when taken on their own and in low doses, she notes. But when you’re taking several opioids at once, or taking them in high doses, the risk of overdose and death spikes.

A growing problem

“With the aging of our population, people need more and more medication for chronic conditions and for sleep problems. This has helped to fuel the opioid epidemic,” Dr. Casserly notes.

For example, when taking these common medications with opioids, their potency multiplies:

“Physicians don’t knowingly prescribe such drugs together,” says Dr. Casserly. “It happens inadvertently. For example, a patient may fill a benzodiazepine prescription from their primary doctor. Then, maybe months later, they’ll fill an opioid prescription from their pain doctor.”

Why opioids are the go-to pain drug

Other pain medications are less addictive and cause fewer interactions. So why have opioids become so popular?

“They’re like a shotgun, instead of a rifle — they have a broad effect on many types of pain,” explains Dr. Casserly.

In contrast, other medications help only with specific types of pain. “For example, medication for nerve pain won’t work for inflammatory pain, and vice versa,” she says.

Alternatives to opioids

Because of potentially deadly interactions, physicians are encouraged to prescribe opioids only as a last resort. So Dr. Casserly often suggests alternatives for the three major types of pain:

Worried about drug interactions?

Talk to your doctor’s office or neighborhood pharmacist if you’re concerned that a painkiller may interact with your other medications. “Your pharmacist can work with your physician to problem-solve and explore alternatives,” says Dr. Casserly.

But be sure to talk to your physician if you’re worried about how you or someone you love is taking pain medication, as that may be a sign of addiction.