Opioids for pain relief: The Kent Centre for Pain Medicine and Neuromodulation
Information for patients
This leaflet will give you information about opioids for pain relief. If you have any questions, please ask your GP or other relevant healthcare professional.
This opioid prescription should not be continued indefinitely. You need to arrange an opioid prescription review with your GP.
What are opioid medications?
Opioids are powerful pain medications that work in a similar way to morphine. They are used to treat some pain if other methods of reducing pain are not effective.
Are there different types of opioids?
There are many different types of drugs in this group. Some examples are codeine, tramadol, morphine, oxycodone, buprenorphine, fentanyl, and tapentadol. The strength varies depending on the drug.
What are the ways that I can take opioids?
Opioids can be taken as liquids, tablets, slow release tablets, and skin patches. Each has its own advantages and disadvantages. Your healthcare team or GP will suggest the best one for you, based on your condition and pattern of pain.
For chronic pain, a slow-release tablet or an opioid skin patch will give you a steady level of medicine, which is the best way to manage continuous pain. Fast-acting opioid drugs and opioids, which can be injected, are not very useful for managing continuous pain.
Will these medications take away my pain completely?
Opioid drugs can help manage some types of pain. Some pains may need opioids together with other sorts of medication. Other pains will not respond to opioids and might respond better to other drugs. It is unusual for opioids to take away your pain completely.
The aim of treatment is to reduce your pain enough to help you do more with your life. These medications are commonly combined with other painkillers to improve benefit and reduce side effects. They work best if you combine them with:
other ways of managing symptoms, such as regular activity and exercise
doing things which are satisfying or enjoyable, such as work, study, and social activities
Setting goals to help improve your life is an important way to see if these drugs are helping.
What are the side effects?
The most common side effects of these types of drugs are:
dizziness
nausea (feeling sick)
vomiting (being sick)
drowsiness (feeling tired)
constipation (not pooing as often or finding it hard to poo)
confusion
itchiness
reduced sex drive
sweating
dry mouth
facial flushing
mood changes
Some of these side effects will get better over time.
Side effects like nausea and constipation can be managed by taking additional medications. If you experience any side effects, talk to your healthcare team or GP. If the side effects become intolerable they may suggest an alternative opioid drug or a different preparation.
Are there any dangerous side effects?
Opioids can cause difficulty in breathing or reduced consciousness, especially at night. This is most common if you are overweight and snore heavily. Care must be taken to use only the prescribed dose and to keep these medications away from children.
What are the long-term effects?
When taken at high doses over a long period of time opioids can cause effects, such as:
reduced fertility
low sex drive
irregular periods
erectile dysfunction (the inability to keep an erection)
weight gain
reduced immunity
increased levels of pain (opiate induced hyperalgesia)
Some of these are due to changes in hormone levels in your body. Your healthcare team or GP might suggest a blood test at regular intervals to keep a check on this.
Can I use these medications while pregnant or breastfeeding?
Avoid opioids if you are pregnant, planning on becoming pregnant, or breastfeeding. Please discuss this with your healthcare team or GP.
Is it safe to drink alcohol when I am taking opioids?
Alcohol and opioids together cause sleepiness and poor concentration. Avoid alcohol completely when you first start on opioids or when your dose has just been increased. When you are on a steady dose of opioid, you may be able to drink small amounts of alcohol without having any extra unusual effects.
Will I be able to work?
When you start on opioids, to start with you may feel some drowsiness or poor concentration. Once established on a stable dose you should be able to carry on with normal activities. When you increase or change the dose or formulation you must take care when driving or operating machinery.
If you feel unsafe at work or at home, tell your employer or family. Speak to your GP if you are having problems with normal activities. Discuss with your employer if there are any special regulations relating specifically to your area of work.
Will I be able to drive?
The law in the UK allows you to drive if you are taking opioid medicines. However, opioids can affect your ability to drive, by making you feel dizzy or sleepy.
Laws on drug driving make it illegal to drive if drug levels in your blood are above a specified limit. You would not be committing an offence, as long as the drugs are not affecting your ability to drive safely, and:
you take the drugs to treat a medical condition
you take the drugs as prescribed by your healthcare team or GP
Do not drive if you do not feel capable of driving. There is no defence for dangerous or unsafe driving. If you increase or change your dose or formulation, do not drive until you know how it affects you. Do not drive if you feel unsafe.
You are responsible for making sure you are fit to drive. The Driving and Vehicle Licensing Authority (DVLA) is the only organisation that can advise you about your legal right to hold a driving licence. Tell the DVLA and your insurance company that you are taking opioid medicines.
What is the right dose for opioid painkillers?
Opioids do not have a standard dose. The right dose for these painkillers is the one that gives you the best pain relief with minimal or tolerable side effects.
We usually start opioids on a low dose and increase the dose slowly to achieve the best effect. This dose will vary from person to person. Your GP will advise you.
You will be advised to gradually stop the drug if:
you have not noticed significant benefit after changing your dose two or three times; or
the medicines give you unpleasant side effects.
Only stay on opioids if you notice a very definite improvement in your quality of life.
Do I always have to continue to take these drugs? When can I stop them?
This depends on your symptoms. You may be able to gradually reduce your dose if your symptoms improve.
Do not suddenly stop taking these medications without medical advice. This may result in withdrawal symptoms, especially if you have been on them for a period of time. Withdrawal symptoms may include:
tiredness
sweating
runny nose
stomach cramps
diarrhoea (loose or watery stools (poo))
aching muscles
If you would like to stop taking these drugs, speak with your healthcare team or GP. If needed they can help reduce the dose slowly over time, before completely stopping it.
Will I become addicted to these drugs?
Addiction is unlikely to happen in patients taking opioids for pain relief, especially when you stick to the prescribed dose. People who are addicted to opioids can:
feel out of control about how much medicine they take or how often they take it
crave the drug
continue to take the drug even when it has a negative effect on their physical or mental health
Addiction is more common if you have been addicted to opioids (including heroin) or other drugs (or alcohol) before.
Addiction may also be more common in people with severe depression or anxiety. This does not mean that you will become addicted if:
you have had an addiction problem before; or
if you are very depressed and anxious.
It means that you may be more likely to become addicted than someone who has not had these problems. Most people do not become addicted. Please let your healthcare team or GP know of any concerns, so that they can take necessary precautions.
Over time your body may get used to the pain relieving effects of opioids, so you may need higher doses. This is called tolerance and it is not addiction.
Useful information
World Health Organization: 5 moments for medication safety or World Health Organization: 5 moments for medication safety: infographics
[Web sites last accessed 8 September 2026]
Remember
All patients on opioids should be reviewed regularly.
Many patients only need these strong painkillers for a short period of time.
Never change the dose of opioid yourself. Always speak to a healthcare professional first, such as the hospital doctor, specialist pain nurse, pharmacist, or your GP.
Speak to a doctor, nurse, or pharmacist. Ask questions and find the answers about opioids. These are strong painkillers, so please ask as many questions as you need. Make sure you fully understand what you are being prescribed and why.
Some questions you may wish to ask
What are the risks and benefits of taking an opioid?
Is there an alternative way of managing my pain?
What should I do if I have side effects, and how can they be managed?
Can this medicine interact with other medications I am taking?
When should I get this opioid reviewed and by whom?
What if I want to stop taking an opioid?
What should I do with leftover or expired opioids?
Ask 3 Questions
There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:
What are my choices?
What is good and bad about each choice?
How do I get support to help me make a decision that is right for me?
Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.
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