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Managing pain medications .

“How can I minimize my pain medications but have enough medication to treat my pain?”
“How do I maintain my current level of pain medications?”

  • It can be hard to find the right amount of medicine to control your pain while avoiding drug side effects.
  • It’s best not to expect to become pain free if you’ve experienced chronic pain for a long period of time. There may be no medical solutions that can completely eliminate your pain. Accepting that you’ll have to live with some level of pain is the first step in managing your pain and restoring your life.

If your current level of medications is controlling your pain adequately but you are worried about needing higher doses in the future, here are some things you can do:

  • Try lifestyle changes (not smoking, exercises, lose weight if you are overweight).
  • Try non-medication approaches to manage pain (like support groups, talk therapy, massage, acupuncture).
  • Work with your doctor to adjust your medications to include more non-opioid medications.
  • Multidisciplinary pain management program.
  • Make sure you get the most out of the medications you are taking (see ‘tips’ below).

You may be able to reduce the amount of prescription painkillers you take and manage your pain effectively.

  • Keep a short-acting painkiller with you for emergency use. Sometimes just knowing that you have something in your back pocket that can help ease the pain gives you the peace of mind to reduce your dose and be more active.
  • Work with your doctor and pharmacist to balance your use of long-acting and short-acting medications. This can take some trial and error.
  • Lifestyle changes may ease your pain, like doing the right exercises, working on your posture, not smoking, and relaxing more.

Tips: Getting the most out of your medications 

Many people don’t take their medications as prescribed. It’s hard to remember all the instructions when you have many medications to take at different times during the day. These tips may help.

  • If medications aren’t taken correctly, they may not help at all or they may be harmful. For example, some medications can be taken only on an empty stomach, some on a full stomach (such as NSAIDS). It’s important to keep track of this because it will affect how well your body absorbs the medicine. Some medicines lose more than half their effectiveness if these instructions are not followed.
  • Pill boxes help you keep track when you’re taking more than one or two medications.
  • Colorful stickers on your pill containers serve as good reminders of when to take your pills. 
  • Reminders work. Set alarms on your smart phone or microwave or oven. Ask someone to help you remember when to take your pills.
  • If you travel frequently, keep a few days’ supply of your medicines in your carry-on luggage so you can take your pills on schedule.
  • If you are taking any opioids, keep them locked or hidden so that no one steals them from you.
  • Don’t tell others that you are on an opioid medication to avoid the risk of someone stealing them from you. This is more common than you think.
  • Make sure you tell the doctor or pharmacist what other medications you are taking, including nonprescription drugs, herbal supplements or teas, and drugs prescribed by other doctors. Some drugs can interfere with other treatments and/or be harmful.
  • Ask a pharmacist for help.

It’s important to know that there are new laws in some states that restrict how doctors can prescribe opioids.

Please watch this short video:

Options for tapering opioids

This section is for people who are interested in lowering (tapering) or stopping their opioids.

There are many ways that you and your doctor can taper your opioids.
Usually doctors taper opioids over the course of a few months or years, depending on how much you’re taking and how long you’ve been taking them.
You can also taper them faster (over a few weeks or even over just a few days).
Here are four common tapering regimens.
1. Slowest (over years) is usually recommended for people taking high dose opioids for many years.Doctors lower the dose by 2-10% every 4 to 8 weeks, pausing when needed.
2. Slower (over months) doctor’s lower the dose 5-20% every 4 month.
3. Faster (over weeks): Doctors lower the dose 10-20% every week.
4. Rapid (over days): Doctors lower the dose  20-50% on the first day, then go 10-20% lower every day.

There are many different ways to help people lower their opioids. There are outpatient programs, inpatient programs, group sessions, and even some that can be done over the phone. For example, mindfulness meditation consists of 2 hour group sessions once a week for 2 months, followed by 30 minutes a day of at-home practice. Talk to you doctor about what’s available near you and how fast (or slow) you’d like to taper.

Whichever taper you and your doctor choose, there will be some life changes involved. Your pain may temporarily get worse and you may experience opioid withdrawal symptoms (especially with a rapid taper). But the benefits are many and include less pain, better function, and better quality of life. Patients who lower their opioid doses report much less pain interference.

Let your doctor know how fast or slow you’d like to taper your opioids. Remember, whichever you prefer, tapering should always be done under your doctor ‘s supervision.
Please select which tapering time frame makes most sense to you: