A pain specialist physician answers your questions

If you’re taking short-acting opioids, you can take the medication as needed. However, if you’re taking a long-acting form, it’s important to follow your doctor’s instructions.

If you would like to reduce the dose of your long-acting opioid, it would be a good idea to talk to your doctor. You can also talk to your pharmacist and he can contact your doctor.
 

Opioid pain medications are controlled drugs that can be dangerous. Unfortunately, they are abused by many users. For safety reasons and to help users to take their medications as prescribed, the quantity of medications they can be given is often limited.

If we’re talking about equianalgesic doses, hydromorphone 2 mg in tablet form is equivalent to 10mg of morphine in tablet form.

Yes, for acute pain, for example, postoperative pain, a fracture or tooth extraction. A user who is receiving methadone treatment often needs a higher-than-usual dose of opioid pain medication because of his higher tolerance and because the pain may not be relieved by the usual dose. The dose of the opioid will then have to be tapered to prevent withdrawal. In this type of situation, the patient may relapse and abuse the tablets prescribed for him.

Prescription opioids are effective for treating some types of pain, for example, pain after surgery or from an injury. They are not effective for functional pain such as migraine, fibromyalgia or irritable bowel. It’s important to know that other families of drugs can relieve pain. The choice of product is usually determined based on the type of pain you have. Your doctor may decide not to use an opioid because it is not an effective option for your medical condition.

Some tablets are meant to release the medication over 12 and sometimes 24 hours. This is called extended-release medication and the goal is to provide long-lasting relief. Chewing or breaking the tablet can change how long the medication is effective for. You will not be relieved for the full length of time.

It’s not so much a matter of dose as type of pain. For acute pain, which shouldn’t last long and should be relieved fairly quickly, it’s appropriate to use short-acting opioids, with some prescribed on an as-needed basis. This way, treatment can be adjusted to the user’s rapidly evolving situation.

For subacute pain, which will probably last longer, it’s appropriate to provide baseline analgesia with a long-acting opioid.