Common concerns about opioids in palliative care

By: Canadian Virtual Hospice Team

Unfortunately, many myths and misunderstandings about opioids prevent people from receiving adequate pain control. This article discusses some of these concerns.

Won’t I become addicted?

  • It’s very uncommon for people to become addicted to opioids when:
    • They’re used as prescribed in palliative care to manage symptoms.
  • The body does become used to the medication, which means the dose may need to be increased. This is referred to as tolerance and is different from addiction.
  • The healthcare provider can ask certain questions that will help them know if there’s a risk of addiction. 
  • Addiction may happen if there’s an overwhelming preoccupation with getting more medication when there’s no medical need for it.
  • A small number of people are at serious risk of becoming addicted.
  • According to the Centre for Addictions and Mental Health, a simple way to describe addiction “is the presence of the 4 Cs:
    • Craving
    • Loss of control of amount or frequency of use
    • Compulsion to use
    • Use despite consequences.”

I don’t want to start morphine too soon because it won’t work when I really need it.

  • There’s no scientific or medical basis for this concern. 
  • Opioids such as morphine can be used effectively in palliative care for as long as they’re needed.
  • The best way to manage pain is to control it early.

Those drugs will speed up my disease.

  • Opioids don’t affect how an illness progresses. They simply help to manage pain associated with the illness.

If I take morphine, I won’t be able to drive my car.

  • If the medication makes you sleepy, then it isn’t safe to drive. 
  • If the dose you’re taking is stable (no recent adjustments) and isn’t making you sleepy, then you’re probably safe to drive. 
  • Check with your healthcare provider to be sure. 

Opioids in the home

Safe storage of medications including opioids.
  • It is important to keep all medications in a safe place away from children and pets. Some people choose to have a lockbox in the home.
Safe disposal of opioids.
  • Talk with your healthcare provider or pharmacist about the safe disposal of used opioid medication patches.
  • Take unused opioids, that are no longer needed, to a pharmacist for safe disposal.

 

Updated January 2022

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