Opioids

Opioid medications are synthetic cousins of opium and the drugs derived from opium, such as heroin and morphine. These drugs are often prescribed for acute pain that stems from traumatic injury, such as surgery or a broken bone. Opioids currently cause the most prescription drug-related overdose deaths in the United States — and that rate is still rising. Because the risks are so great, opioids are used at the lowest dose possible, usually for just a few days.

• Generic (brand) names. Hydrocodone (Hysingla ER, Zohydro ER); hydrocodone-acetaminophen (Norco, Anexsia 5/325, others); fentanyl (Actiq, Duragesic-100, others), oxycodone (OxyContin, Roxicodone, others); oxycodone-acetaminophen (Percocet, Roxicet, others); others
• How they work. Opioids, just like real opium, mimic the natural pain-relieving chemicals — called endorphins — produced by your brain. These drugs "turn down the volume" on the pain signals your nervous system sends through your body. They also muffle other nerve cell functions, such as your breathing, heart rate and level of alertness.

• Benefits and risks. Research shows that over time, your body adapts to these medications, and they bring less and less pain relief. This phenomenon, known as tolerance, means that you need more of the same medication to achieve the same degree of pain relief. Long-term use of opioids may lead to dependence on these medications and, eventually, addiction.

  The longer you use opioids, the greater your risk of becoming addicted. However, even using opioids to manage pain for more than a few days increases your risk. Researchers at Mayo Clinic have found that the odds you'll still be on opioids a year after starting a short course increase after only five days on opioids.

• Bottom line. Opioids are a last resort for chronic pain management. They may be the right choice for long-term pain related to cancer and its treatments or, in rare cases, noncancer pain that hasn't responded to any other medications. Because the risks are so serious, you'll need careful and frequent follow-ups with your doctor if you use opioids long term.

While there isn't a cure for chronic pain, many effective pain medications are available to help you function effectively and enjoy your days. As you try different drugs, alone or in combination, work with your doctor to target the simplest long-term solution possible. Keep your medication risks to a minimum to improve your odds of many good days, for many years to come.