Opioids/Substance use

What are opioids?

Percocet. Vicodin. Morphine. Oxycodone. These are just a few of the opioid medicines you may have been given after having a tooth pulled, spraining your ankle or having minor surgery. Prescription pain relievers are cousins of heroin. In fact, 80% of people who use heroin started with prescription pills. New information from the U.S. Centers for Disease Control and Prevention (CDC) tells us it only takes four to five days to become hooked on pain medicine. The risk goes up every day after that. Two people die in the U.S. by accident every hour from prescription opioids (narcotic pain medicines). Most of these are people taking other people’s medicine. Besides the risk of addiction from these drugs, if you take too much, you could stop breathing and die. The highest risk of overdose is in the first 24 to 48 hours. Taking them with alcohol or medicines for anxiety (like Valium, Ativan or Xanax) can increase the risk of death. A mixture of Ibuprofen (Motrin, Advil) and acetaminophen (Tylenol) has actually been proven to work much better for a new pain. These over-the-counter pain relievers also work better than narcotic pain medicine for pain after minor surgery and kidney stones. If pain has been going on a long time (chronic), talk to your doctor. They can prescribe other medicines or treatments that work much better than opioids and will not cause addiction.

Naloxone can save lives

Naloxone, or Narcan, is a life-saving drug that can reverse an overdose for a short time until the person can be treated. If you or a friend or family member is using these medications, it is recommended that you have naloxone on-hand. As of June 9, 2017, anyone in Arizona can pick up naloxone from a pharmacy without a prescription. Your doctor or pharmacist can explain when and how to use it. You could save a life! For more information about the opioid epidemic in Arizona, visit the Arizona Department of Health Services’ opioid site.

Like all medications, opioids have risks. Here are just a few. You should speak with your doctor about these risks before starting an opioid:

  • Constipation: This is a very common side effect of opioid treatment and can be severe.
  • Dry mouth
  • Problems breathing while asleep
  • Lung and heart problems: This happens due to lack of oxygen over time from your brain not signaling your body to breathe.
  • Sleepiness: This raises the risk of falling and accidents. You should not take these medicines when driving or using heavy machinery.
  • Low sex hormones: This can cause low sex drive and loss of your menstrual cycle.
  • Increased sensitivity to pain: After being on an opioid for a long time, the body becomes extra sensitive to things that are usually not painful. This makes you want to increase your dose even more.
  • Dependence: Your body begins to rely on these medications. If you stop taking the drug too quickly, you will go through withdrawal.
  • Addiction: According to The National Alliance of Advocates for Buprenorphine Treatment (NAABT), addiction is strong cravings and an inability to control drug use. It means you continue to use even though you know you are doing harm to yourself or others.
  • Accidental overdose or death: The risk is even higher when combined with alcohol, muscle relaxers, sleep medicines, or drugs for anxiety or seizures.

What does opioid dependence look like?

Opioid dependence is when your body starts to rely on the drug to feel normal. If you stop taking the drug too quickly or reduce your dose, you may have withdrawal symptoms. These can include:

  • Rapid heart rate
  • High blood pressure
  • Sweating
  • Shaking
  • Confusion
  • Seizures
  • Seeing things that aren’t there

If you think you may be dependent on opioids, speak with your doctor about how to slowly reduce your dose safely to avoid withdrawal.

During pregnancy, most all substances in your blood can pass to your baby. Neonatal Abstinence Syndrome (NAS) may occur in the baby after birth if a mother took certain drugs or medicines, usually opioids, such as heroin or methadone, or prescription drugs, such as Vicodin or Percocet during pregnancy. At birth, the baby is cut off suddenly from the medicines or drugs in the mother’s body and within 1-5 days may start to show signs of withdrawal. This is NAS. It is best to stop using most medications, drugs and other substances to give your baby the best chance to be born healthy.

  • Stopping suddenly can cause severe problems for you and the baby.
  • Talk to your health care provider about the best way to stop.
  • Getting treatment can help you stop and is safer for your baby.

For more information about NAS, you can read “Having a Healthy Baby Begins Today: Pregnancy and Common Drugs or Medications” created by the Arizona Department of Health Services. English | Español

If you think you may be addicted, the good news is there are many places to go for help. It’s important that you talk with your clinical team or provider. To find Mercy Care treatment providers, visit our online provider directory. Once you select your health plan you can search for “Addiction Medicine” under Specialists. You can also call Mercy Care RBHA Member Services at 602-586-1841 or 1-800-564-5465 (TTY/TDD 711). They are available 24 hours a day, 7 days a week. *You can also check https://www.samhsa.gov/find-help and http://substanceabuse.az.gov/. *Prior authorization may be required for some providers.

What if you have leftover medicine after your pain goes away? Do you have teenagers in the house? Someone who comes to do home repairs? It’s common for people to go through other people’s medicine cabinets looking for these drugs. It’s very important to dispose of any leftovers. Go to http://www.acpa.net/arizona_drug_disposal_locations.aspx for a map of disposal sites all across Arizona.

What if you don’t want medication for pain?

Do you have chronic pain due to fibromyalgia, irritable bowel syndrome (IBS), headaches, back, neck, or joint pain, or even post-traumatic stress disorder (PTSD)? If you would rather not treat your pain with medication, The Pain Project might be the answer for you. The Pain Project is a group of passionate chronic pain and behavioral therapists based in Arizona. They have made it their mission to improve people’s ability to self-manage their chronic pain and reduce the need for opioids. The Pain Project also has an online portal where you and others with chronic pain can provide support for one another. Those who care for people with chronic pain can also connect to the online portal for support. You will “see” a pain therapist through video chat. This therapist will use mindfulness, talk therapy and community treatment to help you learn how you can help yourself. By using the skills you learn, you will feel better and be able to do more. These skills will also decrease your opioid use and the need for doctor visits or visits to the hospital for pain. For more information, visit www.thepainproject.com.

To find Mercy Care pain management providers, visit our online provider directory. Once you select your health plan you can search for “Pain Control” under Specialists. You can also call Mercy Care RBHA Member Services at 602-586-1841 or 1-800-564-5465 (TTY/TDD 711). They are available 24 hours a day, 7 days a week.