Prescription Opioids

Side Effects

In addition to the serious risks of addiction, abuse, and overdose, the use of prescription opioids can have a number of side effects, even when taken as directed:

• Tolerance—meaning you might need to take more of the medication for the same pain relief
• Physical dependence—meaning you have symptoms of withdrawal when the medication is stopped
• Increased sensitivity to pain
• Constipation
• Nausea, vomiting, and dry mouth
• Sleepiness and dizziness
• Confusion
• Depression
• Low levels of testosterone that can result in lower sex drive, energy, and strength
• Itching and sweating

Learn More: Prescription Opioid Data

When the Prescription Becomes the Problem

• Providers wrote nearly a quarter of a billion opioid prescriptions in 2013—with wide variation across states. This is enough for every American adult to have their own bottle of pills.¹
• Health care providers in the highest prescribing state, Alabama, wrote almost three times as many of these prescriptions per person as those in the lowest prescribing state, Hawaii.²
• Studies suggest that regional variation in use of prescription opioids cannot be explained by the underlying health status of the population.²
• The most common drugs involved in prescription opioid overdose deaths include:
  • Methadone
  • Oxycodone (such as OxyContin®)
  • Hydrocodone (such as Vicodin®)³

To reverse this epidemic, we need to improve the way we treat pain. We must prevent abuse, addiction, and overdose before they start.

Risk Factors for Prescription Opioid Abuse and Overdose

Research shows that some risk factors make people particularly vulnerable to prescription opioid abuse and overdose, including:

• Obtaining overlapping prescriptions from multiple providers and pharmacies.^7,8,9,10
• Taking high daily dosages of prescription pain relievers.^8,11,12,13
• Having mental illness or a history of alcohol or other substance abuse.¹⁴
• Living in rural areas and having low income.¹⁵

Medicaid Patients

• Inappropriate prescribing practices and opioid prescribing rates are substantially higher among Medicaid patients than among privately insured patients.
• In one study based on 2010 data, 40% of Medicaid enrollees with prescriptions for pain relievers had at least one indicator of potentially inappropriate use or prescribing:⁹
  • overlapping prescriptions for pain relievers,
  • overlapping pain reliever and benzodiazepine prescriptions,
  • long-acting or extended release prescription pain relievers for acute pain, and
  • high daily doses.

Addiction and Overdose

Anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction.^4,5,6 Once addicted, it can be hard to stop. In 2014, nearly two million Americans either abused or were dependent on prescription opioid pain relievers.

Taking too many prescription opioids can stop a person’s breathing—leading to death.

Prescription opioid overdose deaths also often involve benzodiazepines. Benzodiazepines are central nervous system depressants used to sedate, induce sleep, prevent seizures, and relieve anxiety. Examples include alprazolam (Xanax®), diazepam (Valium®), and lorazepam (Ativan®). Avoid taking benzodiazepines while taking prescription opioids whenever possible.