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Opioid pain medications include a broad range of drugs, such as morphine, codeine and oxycodone. They are marketed under many different brand names, including Percocet«, OxyContin«, and Tylenol No.1« (see the Need More Info? section below for a list of common prescription opioid pain medications approved for sale in Canada.)
When used as directed, opioid pain medications are effective and the side effects (e.g., drowsiness, nausea, constipation, etc.) are generally manageable. However, abuse of these medications can have serious health effects and may lead to addiction.
There are many types of pain medications on the market, including acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs, such as acetylsalicylic acid (ASA) and ibuprofen), corticosteroids (often called steroids) and opioids. Different types of pain medications help to manage different kinds of pain, and like other medicines, they all carry some risk.
Opioid pain medications are generally used to manage moderate to severe pain, which may be acute (e.g., short-term pain following surgery) or chronic (e.g., long-term pain associated with a medical condition, such as different types of cancers). They may also be used to control moderate to severe cough, control diarrhea, and treat addictions to other opioids, including street drugs like heroin.
Opioid medications come in many forms, including tablets, capsules, syrups, solutions, nasal sprays, skin patches and suppositories. The strength of the opioid in these medications varies greatly, and most are available in Canada by prescription only. However, some products containing very low doses of the opioid codeine, combined with at least two other medicinal ingredients, can be purchased directly from a pharmacist. (See the Overdose section below for information about risks associated with taking more than the recommended dose of opioid medications, including those sold over-the-counter.)
Like other medicines, opioid pain medications have side effects, even when used as directed. The short-term effects may include:
In addition, a person taking opioid pain medication may experience the following:
In addition to treating pain, opioid medications can also cause euphoria (a "high"), and this makes them prone to abuse. Patients taking opioid medication for pain may or may not experience a high. However, all opioids have the potential to be addictive. Addiction refers to the compulsive use of a substance, despite its negative consequences. People with a personal or family history of substance abuse, including alcohol, may be at higher risk of addiction to opioid pain medications.
Over the past decade, abuse of and addiction to opioid pain medication has emerged as a public health issue. Abuse of these medicines can cause serious health effects for the user, including a risk of death from an overdose. Drug abuse and addiction to any substance may also cause problems at work or school, and can result in the breakdown of family relationships. In addition, drug abuse can result in financial costs to society for things like healthcare, crime, and lost productivity.
Because of their psychoactive properties (properties that affect the mind and mental processes) and their potential for abuse, opioid pain medications are regulated in Canada under the Controlled Drugs and Substances Act (CDSA). Under the CDSA, it is illegal to:
The following steps will help minimize the risks of using opioid pain medications:
In addition, Health Canada strongly advises against taking any prescription medication that has not been prescribed for you by your health care professional.
Health Canada regulates opioid pain medications under the Food and Drugs Act and the Controlled Drugs and Substances Act. Regulation involves reviewing scientific information about the safety, effectiveness, and quality of these medications before they are authorized for sale in Canada, as well as working to prevent opioid pain medications from being diverted for illegal use.
Health Canada also monitors the safety of health products after they have been approved for sale. Manufacturers are required to provide Health Canada with reports of serious adverse effects for health products they sell in Canada, and consumers and health care providers are encouraged to report adverse reactions via the MedEffect Web site. (See below for a link to MedEffect.)
For more information see Health Canada's Opioid Pain Medications FAQs
You can find more information about specific opioid pain medications by doing an online search of Health Canada's Drug Product Database
When you find the product you are looking for, check to see if there is a product monograph. If there is, open it and scroll down to "Part III: Consumer Information."
Also, see the following Health Canada fact sheets:
Misuse and Abuse of Oxycodone-based Prescription Drugs
It's Your Health articles:
And, visit the Centre for Addiction and Mental Health and search for these resources: "Do You Know...Opioids," "Oxycontin: Straight Talk" and "Is it Safe for My Baby - Pain Medications."
In addition, see the U.S. Food and Drug Administration (FDA): A Guide to Safe Use of Pain Medicine
For information on leaving or entering Canada with prescription opioid pain medications (exemption for travellers)
To report an adverse drug reaction, go to the MedEffect Web section
For more on Health Canada's role, visit the following Web sections:
For additional articles on health and safety issues go to the It's Your Health Web section
You can also call toll free at 1-866-225-0709 or TTY at 1-800-465-7735*
Original: November 2009
ęHer Majesty the Queen in Right of Canada, represented by the Minister of Health, 2009