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NIH MedlinePlus the Magazine, Trusted Health Information from the National Institutes of Health

Chronic Pain

Opioids and Chronic Pain

A photograph of pills spilling from a bottle

Opioids are commonly prescribed because they are effective in relieving many types of pain. These medications are classified as narcotics and can be dangerous when abused. When used properly, opioids such as morphine have long been known to help the severe pain that follows surgery and to alleviate the suffering of people with advanced cancer. Recently, morphine and similar drugs have been used to treat chronic pain not caused by cancer. For many people, they have been remarkably helpful; for others, it either hasn’t worked or has created problems over time.

Taken as directed, opioids can manage pain effectively when used for a short amount of time. With long-term use, people need to be screened and monitored because a fraction of those treated will develop an addiction disorder, abuse the drugs, or give them to others. Long-term daily use of opioids leads to physical dependence, which is not to be confused with addiction disorder. An addiction disorder occurs in about 5 percent of people who take these pain relievers as directed over the period of a year. An addiction disorder can be treated, but like those who misuse or illegally distribute prescription drugs, the prescriber needs to be vigilant to identify and address these problems. That is why everyone who uses prescription opioids needs to be screened and closely monitored.

When people have physical dependence and the opioid use is stopped, withdrawal symptoms include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and involuntary leg movements. Taken in large doses, or in combination with tranquilizers or alcohol, opioids can cause a deadly overdose that causes breathing to stop. To prevent an overdose, it is important to take opioids only as prescribed and to not combine them with other medications unless directed to do so by the prescriber. As clinicians and monitoring systems become more sophisticated, and opioids are better designed to be tamper-resistant or abuse-deterrent, healthcare providers believe that those who suffer because of a fear of addiction will receive the treatment they so desperately need. 

Medicines: Safe Storage and Disposal

Medicines, especially potentially dangerous drugs like opioids, must be safely stored. They should be in a locked container that does not allow others to gain access to them.

Unused portions of medicines must be disposed of properly to avoid harm to others and the environment. Certain medicines, such as opioids, may be especially harmful and, in some cases, fatal in a single dose if they are used by someone other than the person the medicine was prescribed for.

You may have received disposal directions for these medicines when you picked up your prescription. If not, instructions for proper disposal of your prescriptions can be found at DailyMed ( If you properly dispose of these medicines, they cannot be accidentally used by children, pets, or anybody else.

It is important to note that disposal by flushing medicines down the toilet is not recommended for the vast majority of medicines. Unused or expired medicines that do not have flushing directions in the label can be disposed of safely in the household trash by:

  1. Mixing them with something that will hide the medicine or make it unappealing, such as kitty litter or used coffee grounds.
  2. Placing the mixture in a container, such as a sealed plastic bag.
  3. Throwing the prescription bottle in your household trash. If you have questions about disposing of your medicine, please call 1-888-INFO-FDA (1-888-463-6332).

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Spring 2011 Issue: Volume 6 Number 1 Page 9