Everyone who’s experienced pain knows what it is and how it feels. But, everyone’s pain is different. The factors that cause pain are different for each person. Many things influence how someone experiences pain.
There are two types of pain:
- Short-term (acute) pain – pain that lasts from a few moments to days or weeks. It can range from mild to severe.
- Long-term (chronic) pain – pain that lasts more than three months after surgery, an injury, or a condition. When the cause is not cancer, it’s called chronic non-cancer pain.
When pain is persistent it’s difficult to deal with. Caring for someone who has high levels of pain, can be upsetting to see. It’s natural to feel helpless at times.
The pain they feel can affect their mood and make them feel sad or anxious. They might not want to spend time with family or friends. Or, they might miss work or other activities. Pain can stop them from eating the right foods and exercising. It can stop them from getting a good night’s sleep.
Common forms of pain
There are common forms of pain, that:
- can be a symptom of other diseases, or it can be a stand-alone condition
- may show no evidence of its existence
- can occur anywhere in the body, or at multiple sites
- can involve several forms of pain, or just one
- can be daily, or recurrent (such as migraine).
(Adapted from Pain Australia)
There are many aspects to pain management and different pathways to care. Modern pain care uses a ‘whole person’ approach that considers physical, social and psychological factors. It is the most effective way to reduce pain, improve function and mood and reduce disability.
(Credit – Pain Australia).
More information on managing pain is available on the following websites:
Some medicines can play a role within this holistic plan, such as paracetamol and non-steroidal anti-inflammatory medicines.
Sometimes, if an individual has tried other treatments without success, their doctor might prescribe opioid medications. However, opioids play a limited role in the treatment of chronic non-cancer pain and can come with a risk of harm and can be addictive if used long-term.
There are many types of opioids with different names and different brands.
Most people don’t realise that strong pain medicines contain opioids. While the doctor or pharmacist will usually explain that the prescribed pain medicine contains opioids, research has found that many people are taking opioids without realising.
What are Opioids?
They slow down the nerve signals between the brain and the body. This can reduce feelings of pain. But it can also cause side-effects, ranging from constipation to dangerous slowing down of a person’s breathing.
Opioids can also increase hormone levels in the brain (dopamine) that produce feelings of pleasure and pain relief.
(Adapted from NPS Medicinewise)
Opioids are strong pain medications. When lower strength (weaker) pain medications don’t work, opioids are often used. They can help with short-term (acute) pain – like a broken bone or after surgery. They can also help manage pain during a serious illness like cancer.
Opioids are also used to reduce long-term (chronic) pain, such as headaches, back pain, or arthritis. While pain management is important, opioids have a limited role in chronic pain because of a lack of evidence for their long-term benefit.
In a recent survey, over half of participants were taking opioids to treat long-term pain (2020).
Important questions & concerns
The easiest way to find out if pain medicines are opioids is by asking the GP or pharmacist.
Opioids are known by different names so it’s hard to tell by looking at the packet.
The Health Direct website provides details on the ingredients. For example, codeine is one of the weaker opioids while fentanyl and buprenorphine are much more powerful.
Weaker opioids are usually taken as tablets.
Stronger ones can be taken in a range of ways, a few are listed below:
- Nasal spray
- Liquid or syrup
- Patches for the skin
- Tablets held next to the gum
- Quick-acting tablets and capsules
- Slow-release tablets and capsules
- Injections (either into the vein or a muscle).
You may not know if the person you care for is taking opioid medicines. It’s helpful to find out so you can support your loved ones to take their medication safely.
Opioids are generally prescribed with information about safe and effective use. The health professional will only prescribe them when they fully understand the patient, their context, and health condition.
Some people can get good pain relief with opioids in the long term if the dose is kept low and they’re only used from time to time.
Patients with cancer or end-of-life care
Opioids are safe if taken as prescribed. They can be effective to control moderate to severe pain, for example, when someone is in pain during cancer treatment. Or, to help someone live their life as fully and as comfortable as possible when living with a terminal illness (Palliative care).
If you or someone you care for has been prescribed opioids, always ask the doctor or pharmacist for information and advice on how and when to take them. Less than 1 in 5 people using opioids take them in a safe and effective way.
If you’re worried that the person you’re caring for is using their opioid medicines unsafely – find out what you can do to help.
The person you care for may want to reduce how many opioids they take. There are many ways to relieve pain that don’t involve using opioids.
You can learn about other ways to reduce pain instead of opioids, further below.
All medicines have possible side-effects. Opioids are no different. The stronger the medication, the worse the side-effects. The most common ones are:
- feeling sick
- breathing problems – heart rate can slow down to dangerous levels
- increased pain.
Opioids can be addictive
Your body gets used to opioids if taken over a long time. You’d need to take more and more to get the same pain relief you first experienced. Taking higher doses can cause other problems:
Someone you care for might feel conflicted. They might want to stop taking opioids if they’re having side-effects, but they might worry that the pain will come back if they stop.
As a carer, you might find it helpful to encourage the one you care for to speak to their health care team who can offer information and advice. Think about what you’d like to know and write a list of questions to discuss with your GP.
Things to think about…
We understand how hard it can be to stop the medication when it seems like it’s working. Remember – it could also be making things worse in the long run.
If someone you care for has been using pain medicines for a long time, talk to the doctor about the best way to come off them.
Reducing opioid medication should be done slowly otherwise it can cause withdrawal symptoms, like diarrhoea, muscle pains, feeling anxious, sick, or tired.
Bringing the dose down slowly also gives the perfect opportunity to try other ways to cut down pain when opioid free.
Find other ways to support the person you care for.
Listed below are a few ideas to reduce pain without opioids. If you’re caring for someone who needs help to reduce the opioids they’re taking, call your GP today.
There are ways to support the person you’re caring for if they’re in pain. Find out more here.
If you or someone you care for is taking opioid pain medication and keen to try something different – there are other options.
The Australian Health Direct website has plenty of suggestions.
- Over-the-counter medicines
- Non-drug options:
- Meditation or relaxation techniques
- Other therapies:
- Steroid injections or nerve blockers
- Radio waves (also known as Radiofrequency ablation –
Using electric current radio waves to get to the nerve)
- Nerve stimulation (also known as neuromodulation)
- Medical marijuana
New solutions are being developed, tried, and tested all the time.
Should people stop taking opioids?
It’s important to balance the benefits and potential harms of using opioids.
Opioids reduce pain. But taking too many opioid medications can cause harm.
Opioids are effective in reducing short-term, non-cancer pain and pain associated with cancer. Because they relieve pain, it can improve other aspects of life too, for example, going to work or activities, and sleeping better.
The benefits of opioids often become less over time (this is known as tolerance). This can mean that the person taking the opioids will want more to get the same pain reduction. This is when there is a much higher risk of side effects.
The Australian Government are keen to protect the health of the public and have introduced new requirements to get opioid medicines. Find out more here.
The Australian Department of Health is bringing in the new requirements to cut down on opioid use:
- Smaller opioid pack sizes
- Information and clear warnings about potential harm
- Tightening the conditions to get prescriptions for opioids.
Resources and further information
- Checklist: Are you a carer for someone living with pain? Do you want to learn more about their opioid pain medication?
- Factsheet 1: How do I know if the person I’m caring for is taking opioid medicines?
- Factsheet 2: How can I support the person I’m caring for with taking their opioid medicines?
- Factsheet 3: How can I identify if a person I’m caring for is not using their opioid medicines safely?
- Factsheet 4: Will the person I’m caring for still have access to opioid medicines?
- Factsheet 5: How can I help someone living with pain?
More information available from:
- Health Direct
- Pain Australia
- NPS Medicinewise
Chronic Pain Australia
- Australia Pain Management Association
- Asking Painful Questions video series
In the media:
Carers Australia has written the following articles to help medical professionals support carers in pain management:
- Australian Journal of Pharmacy – ‘Engage with carers of patients requiring opioids‘
- ‘GPs urged to educate carers on opioids‘
Did you know…
Opioids are good to reduce short-term extreme pain or pain at the end of life. But there’s little evidence to show they work to reduce long-term pain.
Call your GP today if you care for someone who’s ready to quit opioids.
Pain management and prescription opioids Q&As
Information pack – Opioids checklist and factsheets
7 May 2021 – 1.72 MB