Opioids are medicines often used to treat pain. They can help when taken as directed, but they also carry serious risks, including dependence, opioid use disorder and overdose. Learning how opioids affect your body and how to use them safely can help protect you and the people you care about.
Whether you are taking prescription opioids, supporting someone you care about or looking for help with opioid use, understanding your options can make a real difference. This page includes easy-to-understand information, videos, treatment options, recovery support tools and trusted resources.
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Opioids & Staying Safe
Opioids block pain signals in the brain. They may also make a person feel relaxed, sleepy or very calm. Opioids can slow breathing, especially when a person takes too much or combines them with alcohol or other medicines.
Regular opioid use may lead to:
- Tolerance: Needing a higher dose to get the same effect
- Physical dependence: Having withdrawal symptoms if opioid use is suddenly reduced or stopped
- Opioid use disorder: Having difficulty controlling opioid use, even when it causes problems
- Overdose: Having dangerously slow or stopped breathing
Tolerance and physical dependence can happen when a person takes opioids as prescribed. They do not always mean that a person has opioid use disorder. Talk with your provider before changing or stopping a prescribed opioid.
Opioids are a group of medicines and drugs that affect areas of the brain involved in pain and breathing. Health care providers may prescribe opioids for short-term pain, severe pain, pain after surgery or certain serious health conditions.
All opioids carry risks, including physical dependence, opioid use disorder and overdose.
Common prescription opioids include:
- Oxycodone, including OxyContin® and Percocet®
- Hydrocodone, including Vicodin® and Norco®
- Morphine
- Fentanyl
- Hydromorphone, including Dilaudid®
- Codeine
- Meperidine, including Demerol®
Other opioids include:
- Methadone and buprenorphine, which may be used to treat opioid use disorder
- Heroin, an illegal opioid
- Illegally made fentanyl, which may be mixed into other drugs without a person knowing
Talk with your health care provider or pharmacist if you are not sure whether a medicine you take is an opioid.
Opioid misuse may include:
- Taking more medicine than prescribed
- Taking medicine more often than prescribed
- Taking medicine for longer than prescribed
- Taking an opioid that was prescribed to someone else
- Sharing prescription medicine
- Using opioids for reasons other than pain relief
- Taking opioids to feel “high”
- Crushing, breaking or changing medicine in a way that was not directed by a provider
If you are having trouble taking your medicine as prescribed, tell your provider. Your provider can help you review your pain-management plan and discuss safer options.
Even when opioids are prescribed by a health care provider, they can be dangerous. To lower your risk:
- Take opioids exactly as prescribed.
- Do not take a larger dose or take the medicine more often than directed.
- Do not share your medicine with anyone.
- Do not take medicine prescribed to someone else.
- Do not mix opioids with alcohol or other drugs.
- Make sure your providers know about every medicine and substance you use.
- Ask your provider or pharmacist about possible drug interactions.
- Do not drive or operate heavy equipment until you know how the medicine affects you.
- Keep naloxone, also called Narcan, nearby.
- Store opioids in their original container.
- Keep medicine in a secure place where children, visitors and other people cannot reach it.
Unused or expired opioids should be safely thrown away. Many pharmacies and law enforcement agencies offer medication drop boxes or drug take-back programs. Ask your pharmacist about safe disposal options near you.
Do not flush medicine unless the label or a health care professional tells you to do so.
Benzodiazepines, sometimes called “benzos,” are medicines used to treat anxiety, sleep problems, seizures and other conditions. Examples include:
- Alprazolam, including Xanax
- Diazepam, including Valium
- Lorazepam, including Ativan
- Clonazepam, including Klonopin
Both opioids and benzodiazepines can make a person sleepy and slow their breathing. Taking them together greatly increases the risk of an overdose, loss of consciousness and death.
If you take both types of medicine:
- Make sure each of your providers knows all the medicines you take.
- Take your medicine exactly as prescribed.
- Do not drink alcohol.
- Do not take medicine prescribed to someone else.
- Ask your provider or pharmacist about keeping naloxone nearby.
- Call your provider if you feel unusually sleepy, dizzy, confused or weak.
- Call 911 if you have trouble breathing or cannot stay awake.
- Do not drive or use heavy equipment until you know how the medicine affects you.
Do not stop taking an opioid or benzodiazepine suddenly without talking with your provider. Your provider can help you make a safe plan.
Opioid Use Disorder
Opioid use disorder is a treatable medical condition that can affect a person’s brain and behavior. It may cause strong urges to use opioids or make it difficult to reduce or stop opioid use, even when it is causing problems in a person’s health, relationships, work or daily life.
Opioid use disorder is not a personal failure or a lack of willpower. Changes in the brain can make opioids difficult to stop without treatment and support.
Physical dependence is not the same as opioid use disorder. A person who takes an opioid as prescribed may develop physical dependence without having opioid use disorder. A health care provider can complete an assessment and help determine whether treatment is needed.
Consider talking with a health care provider if:
- You take opioids differently than prescribed.
- You take medicine that was prescribed to someone else.
- You use more opioids or use them for longer than you planned.
- You need more of an opioid to feel the same effect.
- You spend a lot of time thinking about opioids or getting them.
- You worry about running out.
- You have tried to reduce or stop opioid use but could not.
- Opioid use is affecting your health, work, school or relationships.
- You continue using opioids even after they have caused problems.
- Friends or family members have expressed concern.
- You mix opioids with alcohol or other drugs.
- You have had an overdose.
Help is available. A provider can talk with you privately, answer questions and help you find treatment that meets your needs.
Opioids can change areas of the brain involved in reward, stress, decision-making and self-control. These changes may cause cravings, withdrawal symptoms and a strong urge to continue using opioids.
Withdrawal can include:
- Anxiety or restlessness
- Muscle aches
- Sweating
- Trouble sleeping
- Nausea, vomiting or diarrhea
- Stomach cramps
- Chills
- A fast heartbeat
- Strong cravings
Trying to stop opioids without support can be difficult and may increase the risk of returning to use. Returning to the same dose after a break can also lead to an overdose because the body’s tolerance may be lower.
Treatment with medication, counseling and recovery support can help.
Treatment and Recovery
Medications for opioid use disorder can reduce withdrawal symptoms and cravings, help a person stop or reduce opioid use and lower the risk of overdose. Treatment with medication is sometimes called medication-assisted treatment, or MAT.
Medications may include:
- Buprenorphine: Reduces cravings and withdrawal symptoms
- Methadone: Reduces cravings and withdrawal symptoms and is provided through certified treatment programs
- Naltrexone: Blocks the effects of opioids after opioids are no longer in the body
Medication may be used for different lengths of time. Some people benefit from longer-term treatment. Decisions about starting, changing or stopping medication should be made with a qualified health care provider.
Medication is treatment. Taking medication for opioid use disorder does not mean that a person is replacing one addiction with another.
Counseling can help people understand their opioid use, manage stress, identify triggers and develop skills that support recovery.
Counseling may include:
- Individual therapy: One-on-one sessions with a trained professional
- Group therapy: Sessions where people learn and receive support together
- Family therapy: Sessions that help family members improve communication and support recovery
- Cognitive behavioral therapy: A type of therapy that helps people identify unhelpful thoughts and develop healthier ways to respond to stress, pain and cravings
Counseling may be used with medication and other recovery supports.
The right level of treatment depends on each person’s needs. Treatment may include:
Outpatient Treatment
A person lives at home and attends appointments for medication, counseling and recovery support. Outpatient treatment may work well for people who do not need care throughout the day.
Substance Abuse Intensive Outpatient Program
A Substance Abuse Intensive Outpatient Program, sometimes called SAIOP, provides more frequent and structured treatment than regular outpatient care. A person can continue living at home while attending treatment several times each week.
Partial Hospitalization Program
A Partial Hospitalization Program, sometimes called PHP, provides intensive treatment during the day. A person usually returns home in the evening.
Residential or Inpatient Treatment
A person lives at a treatment facility and receives support throughout the day and night. Residential or inpatient care may be appropriate for people who need a highly structured setting, medical support or help with co-occurring mental health conditions.
A provider can help determine which level of care may best meet your needs.
Peer support connects people in recovery with others who have personal experience with substance use and recovery. Peer support specialists can offer encouragement, help people set goals and connect them with services.
Support groups may include:
- Narcotics Anonymous
- Alcoholics Anonymous
- SMART Recovery
- Medication-Assisted Recovery Anonymous
- Local peer-led recovery groups
- Virtual recovery groups
Some people prefer a 12-step program, while others prefer a different approach. You can choose the type of support that feels right for you.
Recovery may involve more than medical treatment. Other services can help people build stability and work toward their personal goals.
Recovery supports may include:
- Care or case management
- Housing assistance
- Employment support
- Transportation
- Food and nutrition resources
- Legal and social service navigation
- Physical and mental health care
- Family and caregiver support
- Help returning to school
- Community activities and social support
Ask your provider, care manager or peer support specialist about services that may be available.
Managing Pain and Preventing Overdose
Options may include:
- Physical therapy
- Walking, swimming or other regular exercise
- Strength and flexibility exercises
- Yoga or tai chi
- Cognitive behavioral therapy
- Mindfulness or meditation
- Massage
- Heat or cold therapy
- Warm baths
- Acupuncture or acupressure
- Spending time with supportive friends or family
- Participating in social or community activities
- Over-the-counter pain relievers
- Prescription medicines that are not opioids
- Injections or other medical procedures, when appropriate
Over-the-counter medicines may include:
- Acetaminophen, including Tylenol
- Nonsteroidal anti-inflammatory drugs, including ibuprofen, naproxen or aspirin
Over-the-counter medicines can also cause side effects or interact with other medicines. Follow the directions and talk with your provider or pharmacist before starting a new medicine.
Your provider can help you compare the possible benefits and risks of different treatments. Do not suddenly stop taking a prescribed opioid. If you want to reduce or stop your medicine, ask your provider to help you create a safe, gradual plan.
The risk of an overdose may be higher when a person:
- Takes more opioids than prescribed
- Uses opioids after a break or period of not using
- Has recently left detox, treatment, a hospital or jail
- Uses opioids with alcohol
- Uses opioids with benzodiazepines or other medicines that cause sleepiness
- Uses heroin or illegally made fentanyl
- Takes a medicine or drug without knowing its strength
- Uses drugs that may contain fentanyl
- Has had an overdose before
- Has certain breathing, liver, kidney or heart conditions
- Uses opioids alone
A person’s tolerance can decrease quickly during a break from opioid use. A dose that did not cause an overdose before may become deadly after a period of not using.
An opioid overdose happens when breathing slows or stops. This can cause serious injury or death.
Ways to lower overdose risk:
- Take only the prescribed dose
- Avoid mixing opioids with alcohol or other drugs
- Be careful after a break from opioids
- Do not use opioids alone
- Keep naloxone available
If you think someone has overdosed, call 911 right away. Naloxone can reverse an overdose.
A person may be experiencing an opioid overdose if:
- They cannot be awakened.
- Their breathing is slow, shallow, irregular or stopped.
- They make choking, snoring or gurgling sounds.
- Their lips, fingertips or skin look blue, gray or pale.
- Their body is limp.
- Their face is pale or clammy.
- Their heartbeat is slow or cannot be found.
- Their pupils are very small or look like pinpoint dots.
When you are not sure, treat the situation like an overdose and act immediately.
- Call 911 immediately.
- Give naloxone if it is available.
- Follow the directions included with the naloxone.
- Give another dose if the person does not respond and the product directions advise it.
- Follow the 911 operator’s instructions.
- Try to keep the person awake and breathing.
- Stay with the person until emergency help arrives.
Naloxone may wear off before the opioid does. A person who wakes up after receiving naloxone still needs emergency medical care.
Naloxone, also called Narcan, is a medicine that can temporarily reverse an opioid overdose. It can restore breathing when opioids have caused breathing to slow or stop.
Naloxone:
- Works on opioid overdoses
- Can be used by people without medical training
- Is commonly available as a nasal spray
- Will not harm a person who is not experiencing an opioid overdose
- May require more than one dose
- Does not replace emergency medical care
People who take prescription opioids, use illegal opioids or care about someone who may be at risk should consider keeping naloxone nearby.
Naloxone may be available through:
- Local pharmacies
- Health departments
- Community organizations
- Syringe services programs
- Overdose-prevention programs
- Mail-order naloxone programs
- Partners community events or programs
Ask a pharmacist whether naloxone is available and whether there is a cost.
Use Naloxone Saves NC to find pharmacies, community organizations and other ways to get naloxone.
The North Carolina Safer Syringe Initiative provides information about syringe services programs. These programs may offer naloxone, sterile supplies, safe disposal, overdose education and referrals to treatment.
The National Harm Reduction Coalition also provides a directory of naloxone and harm-reduction services.
Free Recovery Support Apps
Partners wants members and families to have access to tools that can support recovery from substance use. Free mobile apps are available through CHESS Health in partnership with the North Carolina Department of Health and Human Services.
Connections is a free, evidence-based recovery support app for Partners members. Members can use the app from a phone or other mobile device to connect with peer support, recovery activities and educational resources.
Features include:
- Immediate access to certified peer recovery specialists 24 hours a day, seven days a week
- Virtual groups led by peer support specialists
- On-demand programs based on cognitive behavioral therapy
- A library of recovery information and resources
- Tools for setting and tracking goals
- Daily recovery content
- An adult version for members ages 18 and older
- A youth version for members ages 13–17
To enroll in the Connections app, complete the online enrollment form, scan the QR code on the Connections app flyer, or text your full name, date of birth and Partners Health Management to 610-488-2461.
Companion is a free app for family members, friends and caregivers of people living with substance use disorder or common co-occurring mental health conditions.
It provides a supportive online community and resources that can help people better understand and support a loved one.
Features include:
- A community of people who can share experiences and encouragement
- Support from others who understand the experience of helping a loved one
- Information about treatment and medications
- Resources for family members, friends and caregivers
- A daily “Thought of the Day” for encouragement and reflection
To enroll in the Companion app, complete the Companion app enrollment form or scan the QR code on the Companion Flyer.
Get Support
If you or someone you care about needs help with substance use or opioid safety, support is available. Trusted national organizations provide confidential information, education and treatment guidance. Help is available by phone or in person, and you can choose the option that works best for you.
Substance Use Resources
Talk to Your Provider
Your healthcare providers also rely on evidence-based guidance to support safe opioid use and substance use treatment.