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SafeMedicationUse Newsletter



Informed Consumers Can Help Prevent Harm from Opioid Use!


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2013-03-25

Safe Medication Use.ca has received a report from a consumer about an incident involving hydromorphone and morphine. Both medicines belong to the class of drugs known as "opioids" or "narcotics". Opioids are strong painkillers. These medicines are safe and effective when used properly, but they can cause serious harm if used improperly or in error.

Examples* of opioids include:

  • Codeine (Tylenol #1, #2, #3)
  • Fentanyl (Duragesic)
  • Hydromorphone (Dilaudid, Hydromorph Contin)
  • Morphine (Statex, MS Contin, M-Eslon)
  • Oxycodone (Percocet, OxyContin, OxyNEO)

*This list includes only the most commonly prescribed opioids. If you are unsure whether one of your medicines is an opioid, ask your doctor, nurse, or pharmacist.

The consumer had received an opioid in the past but had experienced difficulty breathing and poor control of pain. Also, the consumer had asthma, which increases the chances of breathing problems when taking an opioid. The consumer was scheduled to have a surgical procedure and provided all of this information to care providers beforehand. However, both hydromorphone and morphine were given to control pain after the surgery. After receiving several doses of the drugs, the consumer stopped breathing and became unresponsive. Treatment in the intensive care unit was required, and fortunately the consumer recovered.

When opioids are used, there is a fine balance between their beneficial effects and their potentially dangerous side effects. If you or a family member requires an opioid, the following information can help you to play an important role in preventing harmful events with these medicines.


Before an opioid is prescribed for you:
  • It is important for your healthcare providers to have complete information about factors that may affect the way your body reacts to medicines. Before receiving or taking a dose of an opioid, be sure to tell your healthcare provider if you
    • are older than 65 years of age
    • have sleep apnea (a sleep disorder in which abnormal pauses in breathing occur)
    • have lung disease (such as asthma, emphysema, or chronic bronchitis)
    • have kidney or liver disease.
  • Taking opioids with certain other medicines or with alcohol can put you at increased risk of harm. Make sure that anyone who is prescribing or dispensing an opioid medicine for you knows what other medicines you are taking. In addition, if you are already taking an opioid medicine, always check with your prescriber or pharmacist before using any non-prescription medicines. More information about keeping and sharing a list of your medicines.

While you are taking or receiving an opioid:
  • Never take or share an opioid medicine that is prescribed for someone else. A dose of an opioid that is safe for one person can cause severe harm or even death in someone who has never taken an opioid drug.
  • If your dose of opioid is not controlling your pain, do not take more opioid medicine than is directed on the prescription label. Instead, speak with your healthcare professional if your pain continues. Depending on the medicine and dosage prescribed, taking an extra pill, or taking the medication sooner than directed, can cause severe harm or even death. If you have difficulty remembering whether you have taken your medicine, use a pill organizer or ask your pharmacist to prepare your medicines in clearly labelled blister packs.
  • Be alert to possible side effects. This is an important way to identify if the amount of opioid is too high. Contact your healthcare providers if you have any unexpected or bothersome side effects or if you are unsure whether something you are experiencing is "normal". Refer to the table below.

Seek advice from care providers on how to manage these common side effects

Contact a care provider if you notice these concerning side effects

Seek immediate medical attention (call 911) if you notice these dangerous side effects

  • Constipation
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Itchiness
  • Nausea and vomiting
  • Sweating
  • Excessive dizziness or faintness*
  • Inability to stay awake*
  • Slurred speech or confusion
  • Difficulty wakening the person from sleep
  • Unusual snoring, gasping, or snorting during sleep
  • Shortness of breath
  • A slow or unusual heart rate
  • Blue or purple lips or fingernails
  • Inability to talk
  • Inability to waken person from sleep
  • Gurgling noises coming from the mouth or throat
  • No breathing or heartbeat

*Excessive dizziness or faintness, and inability to stay awake are two of the first signs that indicate you may be receiving too much opioid medicine.

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