How to Avoid Getting Hooked on Opioids

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Sales of OxyContin, Vicodin, Percocet, and other narcotic pain drugs have quadrupled in the U.S. over the 15 years—as have overdose deaths from these drugs, according to the Centers for Disease Control and Prevention.

Now, a comprehensive survey published today in the Annals of Internal Medicine sheds light on what’s causing the opioid epidemic and points to important steps consumers can take to reduce risks for themselves and the people around them.

Government researchers relied on the 2015 National Survey on Drug Use and Health (NSDUH), a nationally representative survey of 51,200 adults who participated in face-to-face interviews.

They found that opioid use has become routine: About 38 percent of Americans took at least one prescription opioid at some point in 2015.

1. Don’t Overtreat Short-Term Pain

Doctors contribute to the opioid epidemic when they overprescribe opioids to treat pain after a surgery or an injury, reports Compton. A recent CDC report found that some doctors are not following the latest evidence-based guidelines and are still prescribing far too many pills.

But taking opioids for more than three days typically isn’t necessary, and sharply increases your risk of getting hooked on the drugs, according to a recent CDC study.

Talk to your doctor about using safer, over-the-counter pain relievers such as acetaminophen (Tylenol and generic), ibuprofen (Advil, Motrin IB, and generic), and naproxen (Aleve and generic) before using a prescription opioid, advises Consumer Reports’ medical director, Orly Avitzur, M.D. Those can work quite well to alleviate pain after dental work, as well as from minor surgery or injuries, she says.

“If an opioid is warranted, most people can comfortably transition to safer OTC pain drugs within three days,” says Avitzur. “Few people need opioids for more than a week.”

Avitzur also advises talking to your doctor up front to let him or her know that you don’t want more than a few days’ worth of opioids.

2. Ask About Other Options for Pain Relief

Opioids are essential for treating severe short-term pain from surgery or an injury as well as longer-term pain from cancer or a terminal illness, says Avitzur. “But they are not the best first choice for many other types of pain,” she says. For example, other prescription medications work better for nerve pain, migraines, and fibromyalgia and are safer.

When it comes to longer-term pain such as chronic back pain or arthritis, “opioids don’t necessarily relieve pain much better or help you move more easily than OTC pain medications,” she says. And the longer you take them, the greater your risk of addiction and overdose, especially when taking high doses.

There’s also mounting evidence that nondrug approaches such as acupuncture, chiropractic care, physical therapy, tai chi, and yoga can work as well or better than medications to relieve an aching back or joints.

3. Don't Borrow or Share Opioids

The recent NSDUH national survey found that 40 percent of people who misused the opioids got them from friends and family members, making American medicine cabinets one of the primary sources fueling the opioid epidemic.

“There’s a false assumption that if a drug came from a healthcare setting then it must be safe,” says Compton. “But these are powerful medications that have serious risks; they require a physician’s prescription for a reason.”

An opioid dose prescribed for someone else could be dangerous for you, he says, or it could combine with other medications you take in a way that increases the risk of overdose.

4. Don’t Hang On to Leftover Pills

The main reason that so many opioids are available for misuse is that doctors tend to prescribe more medication than needed, and then people wind up storing the unused pills in their medicine cabinet.

Six out of 10 Americans prescribed an opioid keep leftovers, according to study published last year in JAMA Internal Medicine.

“Keeping leftover opioids for future use is a bad idea,” says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser. “It encourages inappropriate use later on, and makes it possible for other people, including children, to get their hands on these potentially dangerous and addictive drugs.”

Many pharmacies now take back unused medications, including opioids. Read more about other easy options of disposing of leftover meds.

5. Get Help If You Need It

The new survey reinforced findings from other research showing that people are more likely to become addicted to opioids if they have a history of depression or suicidal thoughts or if they have had a substance use disorder involving other legal or illegal drugs.

“Social and psychological factors exacerbate pain,” says Lasser. Up to half of people enduring pain for three months or longer also suffer from depression or another mood disorder, research suggests. Some people may also take opioids as a way to “escape from psychic pain,” she says.

Seeking help for mental health issues can help you feel better both mentally and physically and reduces your risk of becoming dependent on opioids. For example, certain treatments—notably mindfulness meditation, relaxation, and cognitive behavioral therapy (CBT)—can ease chronic back pain.

But the survey results also underscore that even people without risk factors can become dependent or addicted to the drugs, says Lasser. “Anyone can be vulnerable.”

If you find that opioids are taking over your life—you are craving the drug between doses, taking more than is prescribed, continue to take it even though it is adversely affecting your health, job, or personal life—and you have wanted to stop or cut back, but couldn’t, talk to your doctor. He or she can refer you to someone who specializes in addiction treatment.

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

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