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There are many myths about painkillers|, especially strong ones such as morphine. These can often cause fears and worries and may lead to pain not being controlled. It can help to know some of the facts about painkilling drugs when you start taking them.
You should start taking your painkillers when you have pain. Many people believe that they should put off using painkillers for as long as possible and that they should only get help when pain is becoming unbearable. This can mean that people are in pain unnecessarily and can also make the pain more difficult to control. There is no need to ‘save’ them until you’re very ill or your pain is severe.
When you’re taking painkillers, always be sure to take them regularly as prescribed by your doctor. The aim is to make sure that the pain control is constant.
If you’ve been given painkillers for breakthrough pain|, don’t wait for it to get really bad before you take them.
It’s important to let your doctors and nurses know if your pain isn’t controlled with your regular painkillers or if you get breakthrough pain. You may need to have your regular dose adjusted, or you may need to have a different painkiller. Remember that it can sometimes take a little time to get the right painkiller and the correct dose to control your pain.
If you have severe pain you may be given a strong painkiller, such as morphine, straightaway. This doesn’t mean that the cancer is more serious, just that the pain is severe. The dose can easily be adjusted as necessary if the pain gets better or worse. Being started on a strong painkiller doesn’t mean you will always need to take it. If your pain improves, you may be able to take a milder painkiller.
You may be given other medicines| such as antidepressants, antiepileptics (drugs that prevent fits or seizures but are also used for neuropathic pain) and muscle relaxants to take with your painkillers. These medicines will also help to control your pain, but will do so in a different way from your painkillers.
Many people who are prescribed strong opioid painkillers such as morphine ask if they will get addicted to it or if they will become confused and unable to look after themselves. This is unlikely to happen. People who become addicted to drugs usually initially choose to take them and then keep taking them because they have a psychological need. For example, they may crave feeling disconnected or ’high’ when they take them. This is very different to someone who is in physical pain and needs to take the drug to control their pain.
Unlike many other drugs, there is no standard dose for morphine or other strong opioid painkillers. The right dose is the one that controls your pain, and this varies from person to person.
If morphine or other painkillers are taken as prescribed, you will not overdose. There is no maximum dose for strong opioid painkillers. However, suddenly increasing the dose is dangerous, so never increase the dose or take extra doses without talking to your doctor first.
If you’re taking morphine or another strong opioid painkiller, it’s important that you don’t suddenly stop taking it. This is because as well as controlling pain, strong painkillers have other physical effects, and if they’re suddenly stopped, you may get withdrawal effects. These include diarrhoea, cramping pains in the stomach and bowel, sickness, sweating, restlessness and agitation.
If you want to stop taking a strong opioid painkiller, you should always talk to your doctor first. Your doctor will tell you how to gradually reduce the dose over a period of weeks or months so that you avoid these withdrawal effects.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.