Opioids are morphine-like drugs that work by binding to opioid receptors, which are found principally in the central and peripheral nervous system and the gastrointestinal tract. The term opioid encompasses both naturally occurring opiates (for example morphine and codeine) derived from the resin of the opium poppy, semi-synthetic (for example oxycodone) and synthetic opioids (for example fentanyl).
Opioids are used primarily for their strong analgesic effect, but may also be used for other indications such as for their anti-diarrheal and cough-suppressant effects. Adverse effects related to opioids include sedation/drowsiness, respiratory depression, nausea/vomiting and constipation. Ongoing administration of opioids may lead to tolerance and dependence.
Opioids are considered to be a high-risk medicine and currently in South Australia. Opioids are the most commonly reported drug class involved in medication incidents, with oxycodone incidents being the number one drug-related incident reported in the SA Health Safety Learning System (SLS).
Opioids for the treatment of pain
Opioids can be highly effective for the treatment of pain, although there is a high-risk of adverse effects and potential for dependence when not used appropriately and other treatment options should also be considered where appropriate. The type, formulation and duration of opioid therapy depends on the clinical indication, for example:
- acute pain
- chronic cancer pain
- chronic non-cancer pain.
The following resources are available to assist healthcare professionals in the use of opioids for the treatment of pain:
- Opioids for Acute Pain Resource Kit
- Analgesia Guidelines - Lumbar disorders
- Opioid pain relievers (NPS)
- Opioid Prescription in Chronic Pain Conditions - Guidelines for SA GPs (PDF 8481KB)
Legal controls for opioid medications
Most opioids are classified as Drugs of Dependence due to their high potential for misuse, abuse and dependence. Drugs of Dependence are subject to specific requirements under the controlled substances legislation, relating to prescribing, supply, storage and transport.
Specific requirements exist for the use of opioids in patients with a known or suspected history of drug dependence and for the treatment of drug dependence.
Treatment for opioid dependence
Treatment options for opioid dependence in South Australia include: