Staying Safe with Opioid Pain Medicines

Pain is a problem for many patients on dialysis, which is many times treated with opioids. It is important to know the risks and benefits of these medicines.

What are opioids?

Opioids are prescription medicines used for severe pain. Examples are morphine, hydrocodone, oxycodone, fentanyl, or methadone. Opioids work well for treating pain, but can have risks. Patients with kidney disease are at high risk for side effects.

What are the risks of opioids?

Common side effects include:
  • Sleepiness
  • Confusion
  • Constipation
  • Nausea or vomiting
  • Dry mouth
  • Tolerance (meaning you may need a higher dose to get the same effect after taking the medication for a while).
Serious risks include trouble breathing, death, or addiction. These risks are higher if too much medicine is taken or if other medicines are taken that interact with opioids, like some anxiety medicines or alcohol. Taking too much medicine is sometimes accidental. Patients with kidney disease are at high risk for side effects.

What are tips for using opioids safely?

  • Communicate with your healthcare providers.
Your doctor(s), dialysis nurses and pharmacist should always know what medicines you are taking. Tell your dialysis nurse whenever you start a new medicine, or when you stop taking one.Ask your doctor how your medicines will be affected by dialysis and when to schedule your doses around your dialysis treatment.
  • Never take more medicine than is prescribed. Talk to your doctor if you are not getting enough relief from your medicine. Taking too much medicine can have serious consequences.
  • Do not share your medicines with relatives, family members or friends.
  • Keep all prescriptions, especially opioids, away from children.
  • Avoid drinking alcohol if you are taking opioid medicines.
  • Your doctor or pharmacist may recommend other medicines to lessen the side effects of opioids. For example, stool softeners or laxatives can be used for constipation.
  • Tell your doctor if you have any serious breathing problems or have had issues with substance abuse in the past.

What is naloxone?

Naloxone is an emergency medicine that can save your life if you have too much opioid medicine in your body. Naloxone is available as a nasal spray or an injectable device. Depending on your state, naloxone may be available over-the-counter at the pharmacy. Ask your doctor or pharmacist if you are a candidate for emergency-use naloxone and how to get it.

Where can I get more information?

Your doctor and pharmacist are good resources for information. The Centers for Disease Control and Prevention website has general information about opioid pain medicines.