Reducing your risks while taking opioid

Reducing your risks while taking opioids
Opioids are a powerful class of medications that are prescribed to relieve pain. They have many side effects; some that make them prone to abuse and some that can even be life-threatening. Anyone taking an opioid is at risk of serious effects, even if the prescription is taken properly. However, there are some people who have a greater risk of experiencing these complications.
Let’s take a look at some of the people who should take extra caution if taking opioids and learn how to reduce these risks.

People taking opioids long-term
Opioids can help with short-term pain, such as pain after a surgery. They can also help with pain from cancer. However, opioids are not always the best way to treat long-term pain, such as pain from arthritis, lower back pain, or frequent headaches. If you’ve been taking pain medications for a long time, you may not get as much pain relief as before since your body has developed a tolerance to the medication. Higher doses of medication are needed to get the same amount of pain relief when this happens.

People with other health conditions
Opioids relieve pain by blocking signals in the nervous system; however, they also affect the part of the brain that controls breathing. When there is too much opioid in the body, breathing slows down and can even stop completely. This can be life-threatening and is a medical emergency. Certain medical conditions can increase your risk of breathing complications. These include:
• respiratory conditions such as asthma, COPD, and sleep apnea
• kidney or liver conditions
• depression or other mental health disorders
• substance use disorder
• previous history of experiencing an opioid overdose

People taking other medications
Combining opioids with alcohol and other medications that may cause drowsiness can increase the risk of slowing your breathing down to a dangerous level. Some of these medications include:
• alcohol
• antidepressants (Citalopram, Amitriptyline, Sertraline)
• antipsychotics (Haloperidol, Quetiapine, Olanzapine)
• antihistamines (BenadrylTM)
• benzodiazepines (Lorazepam, XanaxTM, Clonazepam)
• muscle relaxants (Cyclobenzaprine, Baclofen)
• sleep medications (Zopiclone, Sublinox™)
• illicit or recreational drugs

Special populations
Many personal, social, environmental, and economic factors influence our health. Certain individuals and populations may be more vulnerable to the effects of opioids, including:
• Indigenous populations
• people living in rural communities
• lower socioeconomic status
• homeless populations
• inmates in prisons and penitentiaries
• youth

Consider getting a naloxone kit if you or someone you know may be in the position to reverse an overdose to save a life.

Reducing the risks of opioids
Many people take opioids without any issues. However, serious problems such as overdose and addiction are possible. This is why it’s important to take your medication as prescribed by your doctor.
Due to the potential dangers when opioids are used incorrectly, it’s important to take steps to protect both yourself and the people around you. You should consult with your health care provider about how and when to reduce your dosage if you are currently taking opioids. They can help provide a step-by-step plan and work with you to decrease your dose gradually, ensuring that your pain is well-managed and that you don’t experience any side effects.
If you or a family member have been prescribed opioids, you should store your medication in a secure and locked place to prevent anyone else from using them. Don’t keep opioids in obvious locations, such as bathroom cabinets, where others may easily find them. They should be kept out of reach and out of sight of children, teenagers, and pets. More than two-thirds of students who are misusing or abusing opioids get them from their own homes. You should never share your opioid medication with anyone, as even a small dose can be dangerous and potentially fatal for someone else.
When your opioid medications have expired or you no longer need them, you should safely dispose of them as soon as possible. Don’t keep any unused medications in your home “just in case.” Instead, you can bring your medication to any Shoppers Drug Mart for safe disposal at no charge.

A naloxone kit could save a life
If you or someone you know has any of the above risk factors, you should consider getting a naloxone kit in case of an overdose. Opioid overdoses are often accidental, and can happen to anyone. Having a naloxone kit readily available could save the life of someone you care about during an opioid overdose.
If you’d like more information or want to get a kit, please speak to one of our pharmacists. In many cases, you can get one for free at your pharmacy without a prescription. Naloxone kits are available at all your local Shoppers Drug Mart locations.

References:
1. Ontario Pharmacists Association. Pharmacist Clinical Tool for Initiating Naloxone Discussions. https://www.opatoday.com/Media/Default/Tools%20and%20Forms%20-%20Naloxone/Naloxone%20Clinical%20Tool%20-%2020190918.pdf. Accessed May 27, 2020.
2. Choosing Wisely Canada. (2018). Opioids: When you need them – and when you don’t. https://choosingwiselycanada.org/wp-content/uploads/2018/02/Opioids-When-you-need-them-and-when-you-dont.pdf. Accessed April 28, 2020.
3. Alberta Health Services. Opioids. https://www.albertahealthservices.ca/assets/info/res/mhr/if-res-mhr-hp-opioid-info.pdf. Accessed April 28, 2020.
4. Institute for Safe Medication Practices Canada. Opioids for pain after surgery: Your questions answered. https://www.ismp-canada.org/download/OpioidStewardship/OpioidsAfterSurgery-EN.pdf. Accessed April 28, 2020.
5. World Health Organization. 2018. Information sheet on opioid overdose. https://www.who.int/substance_abuse/information-sheet/en/. Accessed May 27, 2020.
6. L Belzak, J Halverson. Evidence synthesis - The opioid crisis in Canada: a national perspective. 2018 Jun; 38(6): 224–233. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034966/. Accessed May 27, 2020.
7. CAMH. Youth and Prescription Painkillers. https://www.camh.ca/en/health-info/guides-and-publications/youth-and-prescription-painkillers. Accessed May 27, 2020. 8. Choosing Wisely. American Society of Anesthesiologists. Treatments to Relieve Chronic Pain. 2018.
https://www.choosingwisely.org/patient-resources/treatments-to-relieve-chronic-pain/ Accessed may 28, 2020.