Key Facts

    • Opioids are for severe, acute pain. Think post-surgery, a broken bone. They are not the first choice for chronic pain like a nagging backache.
    • These are serious medicines. They work by changing how your brain perceives pain, but they also carry a very real risk of dependence and overdose.

– The biggest danger is slowed breathing. This is how an overdose becomes fatal. This risk is massively amplified by alcohol.

  • If you’ve been on them for more than a few days, you can’t just stop. You must taper off with your doctor to avoid brutal withdrawal symptoms.
  • Naloxone is a miracle drug that can reverse an opioid overdose. It’s available for free in many places. Know what it is.

 

On this page:

When Pain is a Screaming Fire Alarm

I’ve sat with mothers recovering from difficult C-sections, their bodies wracked with a pain that is so much more than just “soreness.” I’ve held the hands of people dealing with cancer pain that is all-consuming. There are times when pain is not just a nuisance; it’s a screaming fire alarm in your brain that blots out everything else. In those moments, you need something that can cut through the noise and give you a moment of peace. That is the intended job of an opioid.

Medicines like morphine, oxycodone, and fentanyl are incredibly effective tools for this kind of severe, short-term (acute) pain. They are a gift of modern medicine that allows people to get through surgery, recover from major injuries, and find comfort in end-of-life care. But they are a tool with a very sharp edge, and we have to treat them with the immense respect they demand.

How They Mute the Alarm (And Why That’s Risky)

So how do they work? Unlike an anti-inflammatory that tries to put out the fire at the source, opioids work directly in your brain. They attach to specific receptors and essentially tell your brain, “You know that fire alarm? Just… ignore it for a while.” They don’t fix the broken bone, but they change your perception of the pain, making it bearable.

But here’s the dangerous flip side. Those same receptors they attach to also control other vital functions, most importantly, your breathing. When you take an opioid, it tells your whole system to slow down. A little slowdown can feel calm and relaxing. But too much, and it can slow your breathing down to a dangerously shallow level, or even stop it completely. That’s how people die from an overdose.

The Slippery Slope: From Tolerance to Dependence

The human body is smart. It adapts. If you take opioids for more than a short time, your brain gets used to them. It starts to need more of the drug to get the same level of pain relief. This is called “tolerance.” It’s not an addiction; it’s a physiological response.

But tolerance can lead to “dependence.” This is when your body has so fully adapted to the presence of the drug that it freaks out if you take it away. If you stop suddenly, you’ll be hit with withdrawal: aches, sweating, nausea, anxiety. It feels like the worst flu of your life. This is why you can’t just quit. You have to work with your doctor to taper—to reduce the dose slowly, bit by bit, to give your body time to readjust.

Addiction is another step further. That’s when you have a compulsive need to take the drug, even when it’s causing harm to your life. Not everyone who takes opioids becomes addicted, but the risk is always there, lurking.

My Unbreakable Rules for Handling Opioids

If you or a loved one is prescribed an opioid, you need a set of rules. No exceptions.

  1. Shortest Time Possible. The goal is to use them to get through the worst of the pain and then switch to a safer alternative like paracetamol or ibuprofen as soon as you can.
  2. Your Pills Are Yours Alone. Never, ever give one of your pills to a friend with a backache. Their body, their other medications, their tolerance—it’s all different. It’s an incredibly dangerous thing to do.
  3. Lock Them Up. Just like any other dangerous substance, these need to be stored securely, away from curious kids, teens, or anyone else in the house.
  4. No Alcohol. Zero. Mixing opioids and alcohol is like pouring gasoline on a fire. Both suppress your breathing. Together, they can be a fatal combination.

The Worst-Case Scenario: What an Overdose Looks Like

You need to know the signs. You could save a life. Someone overdosing on opioids will be:

    • Unresponsive or impossible to wake up.
    • Breathing very slowly and shallowly, or making gurgling/choking sounds.

– Their skin will feel cold and clammy.

  • Their lips and fingernails may look blue or purplish.

 

This is a medical emergency. Call 911 immediately. And please, learn about Naloxone (Narcan). It’s a nasal spray or injection that can literally reverse an opioid overdose and bring someone back from the brink. In many places, you can get it for free from a pharmacy without a prescription. Ask your pharmacist about it. It’s a tool every family touched by opioids should have.