Pain Medication Safety - What You Need To Know

March 8-14 is “Patient Safety Awareness Week”, a time when the medical community looks for ways to improve patient safety.

In the field of pain management, the danger of opioid overuse remains a major area of concern. This has shifted treatment from opioids to pain-relief procedures (Nerve Stimulators, Spinal Cord Stimulators, Pain Pumps, etc.) where the risk for overdose is small or inexistent.

While these procedures have reduced the need for opioids, some people still need various medications to help control their pain. Pain patients, especially the elderly, need to know how to take their prescribed medications in the safest way possible.

Interesting Facts About Medications

(including but not restricted to pain medications)

• 82 percent of American adults take at least one medication and 29 percent take five or more

• Adverse Drug Events (ADEs) such as overdoses and allergic reactions cause approximately 1.3 million emergency department visits each year

• Elderly adults (65 years or older) require a greater number of medications and are three times as likely to come to an emergency department for an ADE when compared to younger patients

• A 2016-2017 U.S. study of 267,020 emergency room visits due to opioid overdoses, showed that most overdoses (47.6%) involved illegal use of opioids, obtained without a prescription, and often mixed with alcohol or other illicit drugs. Only 38.9% of cases were due to legitimate opioid use, with a prescription. The rest (13.5%) were due to intentional self-harm.

These statistics point out the importance of using pain medications (and all medications) according to your doctors’instructions. Elderly adults need to be aware that they have a higher risk of medication-related complications due to taking a higher number of medications. They also have a slower metabolism and removal of medications from the body, due to heart, liver, and kidney diseases.

8 Tips For Taking Your Pain Medications Safely

1. Tell your pain specialist or other health care practitioners about ALL the medications you take. Go over your known allergies and describe any rashes, shortness of breath, stomach upset, dizziness, or mood changes that resulted from taking medications in the past. Make sure to mention all over-the-counter medications, supplements, and herbal remedies since they can interact with your pain prescriptions to create unwanted effects.

2. Understand why you are taking every medication you are prescribed. You may not recall all the details about a new medication during an office visit. Sometimes it helps to have a family member or trusted friend accompany you to your appointment in order to help you recall the basics. Your local pharmacist is a great source of information about medications. Medication pamphlets may also come in handy. Although technical and detailed, they usually have an easy-to-read chart with common side effects.

3. Make a medication list. It is hard to remember all the details about your medications. Make a medication list or print one from the internet. Useful information to have is what each medication does, how often to take it, the dose, common side effects. Some medication lists have a section where you jot down what the pill looks like. However, do not rely heavily on the appearance of pills. Their color and shape may change each time your pharmacist uses a new formulary (a more cost-effective, form of the same prescription drug).

4. Take your medications on time. Many people want to cut down on their medications. When it comes to treating pain, this is a bad idea! Skipping a dose of your pain medications can lead to a pain flareup. You may find yourself in so much pain, that you end up taking a lot more medications than if you would have taken had you stuck to the original schedule suggested by your doctor.

5. Understand which medications you take “as needed” for breakthrough pain. Most chronic pain patients are treated with a long-acting medication, that is taken on a schedule. Examples include Fentanyl Patches, Lidocaine patches, and Extended Release (ER) pills that are designed to release a pain medication slowly to your bloodstream. However, your pain specialist may also prescribe a short-acting medication on an “as-needed basis” for unexpected pain flare-ups. It is important to discuss “as needed” medications with your pain specialist, so you understand how to take them safely.

6. Find ways to remember when to take your medications. Many people forget to take their medications. A pillbox can help you stay on track. Use (cell phone) alarms to remind you when you need to take your medications. Have a plan for situations when you forget to take a medication. Ask your doctor if you can simply take a “catch-up” dose right away or if you should wait until the next scheduled time.

7. Be honest with your pain specialist about how much alcohol or any other drugs you use. Alcohol, and most illicit drugs, can cause dangerous overdoses. Alcohol interferes with important enzymes in the liver and can change how your medications work, enhance their effects, and increase toxicity.

8. Do not stop taking any prescription drug unless checking weight your doctor first. Unwanted effects (anxiety, confusion, sweating) occur if you stop taking antidepressants, opioids, and steroid pills at certain high doses. Always check with your pain specialist before stopping your pain medications.