Opioid analgesics for chronic pain


Generic Name Brand Name
buprenorphine Buprenex
butorphanol Stadol
codeine Tylenol with codeine
fentanyl Duragesic
hydrocodone Vicodin
hydromorphone Dilaudid
methadone Dolophine
morphine Astramorph
oxycodone OxyContin
propoxyphene Darvon

Opioids are available in pills, liquids, or suckers to take by mouth, and in shot, skin patch, and suppository form.

How It Works

Opioid analgesics suppress your perception of pain and calm your emotional response to pain by reducing the number of pain signals sent by the nervous system and the brain's reaction to those pain signals.

Why It Is Used

Opioids are used to reduce moderate to severe chronic pain.

How Well It Works

Opioids are effective in relieving moderate to severe chronic pain. Higher doses may work better, but higher doses also can cause more side effects.

If one opioid does not reduce your pain, your doctor may prescribe a different opioid to treat your chronic pain.

There is a low risk of addiction if you take opioids routinely as prescribed. Your risk of addiction is slightly greater if you have a history of substance abuse.

Side Effects

Opioids may often cause side effects such as:

  • Constipation.
  • Drowsiness.
  • Dizziness.
  • Weakness.
  • Dry mouth.
  • Sedation.
  • Confusion.
  • Difficulty urinating.

More serious side effects can include allergic reaction, such as swelling of the throat, a drop in blood pressure, seizures, tremors, or hallucinations.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

In some cases, more than one type of opioid medicine may be prescribed to relieve pain without increasing the individual dose. Many combinations of opioids with non-opioids have been effective, such as combining opioids with aspirin or acetaminophen.

You may become physically dependent on opioids if you take them regularly. Physical dependence is not addiction but it is a gradual change in your body in response to the opioids. If you stop taking opioids abruptly, you may develop nausea, sweating, chills, diarrhea, and shaking. The physical dependence and withdrawal symptoms are not life-threatening. You can avoid withdrawal symptoms if you gradually stop taking the opioids over a set period of time, as prescribed by your doctor.

Opioid analgesics are potentially addictive, but the risk is small when they are properly prescribed and taken by people who do not have a history of substance abuse. In the past, opioids were used only for short periods for short-term pain or for cancer pain. Many experts now also use opioids for longer periods to treat chronic pain. You can take opioids to reduce pain and increase your functioning without becoming addicted to them.

If you are about to begin a long-term course of opioids, increase the amount of fiber in your diet and drink more water. This will help you avoid constipation. Also talk to your doctor about whether you should take a stool softener or laxative.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Last Updated: January 20, 2009

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