Safe Use, Storage, and Disposal of Opioid Drugs
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What are opioids?
Opioids (say: “oh-pee-oyds”) are powerful pain relievers your healthcare provider can prescribe to manage acute and chronic pain. If you abuse opioids or do not take them correctly, they can cause overdose and even death.
Most opioids come in pill or tablet form and can be taken by mouth. Sometimes, healthcare providers prescribe a potent opioid that comes in patch form (such as fentanyl).
How do opioids work?
Opioids block pain signals in the brain. Many opioids are available in short- and long‑acting forms. Short-acting forms work faster than long-acting forms, but for shorter periods. The long-acting forms – also known by their abbreviations, ER and LA – are used to treat long-lasting pain. Opioids may not safely remove all of your pain, but they will improve your daily function.
Each pain patch contains more medicine than a single pill because it is designed to release medicine over a period of three days.
How do I safely take opioids?
Opioids can cause unpleasant and even dangerous side effects if you take too much, take them too often, or mix them with alcohol, illegal drugs, or even other medicines. Tell your healthcare provider about all other medicines and supplements you are taking to avoid unwanted or dangerous medication interactions. When you get your prescription filled, check the packaging to make sure that it is the right medicine prescribed for you. Read and follow the label directions carefully.
What are the signs of overmedication or overdose?
Anyone using opioids is at risk of overmedication or overdose if they take too much. You are much more at risk of overmedication or overdose if you have never taken opioids.
Some signs of overmedication include:
- Slurred speech, stumbling while walking, dizziness, or confusion
- Excessive drowsiness or difficulty staying alert
- Difficulty waking from sleep
Some signs of overdose include:
- Cannot stay awake or if awake, is unable to speak or be kept awake
- Trouble breathing, including slow, shallow breathing or periods in which breathing stops
- Limpness, lifelessness
- Pale or clammy skin, or blue fingernails or lips
- Slow or stopped heartbeat
What should I do if someone has taken too much medicine?
If you think that someone has taken too much medicine, try to rouse them by using one or more of the following techniques:
- Speak in a loud voice.
- Pinch their ear.
- Rub your knuckles in the middle of their chest.
Call 911 right away if you suspect an opioid overdose or think you may have taken too much:
- Call 911 immediately and tell the operator that you have a medical emergency.
- Give the person naloxone if it’s available, you can give it while waiting for help to arrive
- Give the operator as much information as possible, including your address and any breathing problems that the person may have.
- If the person is having trouble breathing, the operator may ask if you are trained in cardiopulmonary resuscitation (CPR). You might be asked to perform CPR if you are trained to do so.
- After calling 911, stay with the person until emergency services arrive, even if the person wakes up.
Anyone suspected of taking an overdose of opioids should contact a healthcare provider and may need to be considered for counseling and further treatment as appropriate.
Can an opioid overdose be reversed?
Naloxone is a prescription medicine that blocks the effects of opioids. It quickly reverses the breathing problems that result from an opioid overdose. Naloxone can be given by injection to a person who has overdosed.
In Canada, people who might experience or witness an opioid overdose can obtain Naloxone (Narcan) from a pharmacy without a prescription.
How do I safely store opioids?
The abuse of opioids is a significant public safety concern. Teenagers and young adults most commonly get these medicines from their own medicine cabinets, where another family member has stored them. All opioids should be stored in their original packaging inside a locked cabinet, lockbox, or a location where others cannot easily access them.
Carefully note when and how much medicine you take in order to keep track of how much is left. If you think that someone has taken your medicine, contact the police immediately to file a report.
How do I safely dispose of opioids?
You can return unused and expired medications to any pharmacy in Canada, any day of the year. Many communities have medicine take-back programs. Contact your family healthcare provider for more information or visit Health Canada’s website at to learn more. You can also call your local pharmacy to ask if there is a take-back program in your community.
Opioids — both pill and patch forms — often come with instructions for flushing unused medicine to prevent unintentional use or illegal abuse. NEVER flush used and leftover medications or pain patches down the toilet. Even used patches still have enough medicine in them to be dangerous or deadly to pets, children, and others with a low tolerance for opioids. To dispose of a pain patch, fold it in half so the sticky sides stick together, then take it to a pharmacy. If you must dispose of medications in the garbage, remove all identifying information, hide it in something unappealing (used coffee grounds or pet litter) and place them in a closed bag, empty can or other sealed container.
If you are not sure about how to dispose of a medicine, contact your healthcare provider.
Do’s and Don’ts of Opioid Use
Do
- Always remove an old pain patch before applying a new patch.
- Contact your healthcare provider before changing the dosage of your pain reliever. If you miss a dose, do not take two doses without discussing this with your healthcare provider.
- Watch for signs of overmedication and ask others to watch you for those signs.
- When taking liquid doses, use an accurate measuring device and measure out only the prescribed amount.
Don’t
- Do not share opioids.
- Do not combine opioids with alcohol or street drugs.
- Never cut, chew, crush, or dissolve opioid tablets or capsules.
- Never take your pain reliever while in the dark to avoid taking the wrong pill or amount.
- Never cut or fold a pain patch you plan to use.
- Never apply more than one pain patch at a time.
- Never suck on a pain patch.
- Do not expose a pain patch to a source of heat, such as a heating pad, while the patch is attached to your skin.
- Do not change pain patches too often.
- Do not drive a car or use heavy machinery until you have become used to the medicine’s effects.
FOR MORE INFORMATION
Health Canada:
https://www.canada.ca/en/health-canada/services/safe-disposal-prescription-drugs.html
Bibliography
See a list of resources used in the development of this information:
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