Common questions about painkillers

Common questions about painkillers include when they should be taken and whether they have to be taken regularly. If you delay taking them until pain is severe, this can make pain more difficult to control, so it’s important to take them regularly.

Some people ask if having strong pain medicine means their cancer is advanced. This is not necessarily the case. Others worry that they will become addicted to painkillers. This is very unlikely.

If you need to take a strong painkiller, you may ask about the dose you need. The right dose is the one that controls your pain. You should never suddenly stop taking them without medical advice as this can cause withdrawal symptoms.

People also wonder whether they can drink alcohol. This depends on the painkillers. Check if you’re not sure.

When you first start taking some painkillers, or the dose increases, you may get drowsy. It’s a good idea not to drive for the first five days. You may need to tell the DVLA, DVA or your insurance company. Your doctor, specialist nurse or pharmacist can give you advice.

If you are concerned about taking painkillers, talk to your doctor. They will give you advice.

Facts and fears about painkillers

People have different beliefs about painkillers, especially strong ones such as morphine. Some people may feel scared or worried about having these painkillers. This may stop them taking the drugs as prescribed by their doctor, which makes the pain harder to control. It can help to know some of the facts about painkilling drugs when you start taking them.


When should I take my painkillers?

You should start taking your painkillers when you have pain. Many people believe that they should delay using painkillers for as long as possible, and that they should only get help when pain becomes unbearable. But if you do this, it can mean you are in pain when you don’t need to be. It can also make the pain more difficult to control. There is no need to save painkillers until you’re very ill or your pain is severe.

I’d suggest taking painkillers as soon as you start to feel pain, to keep on top of it. I took co-codamol, but I didn’t start it soon enough.

Niamh


Do I have to take my painkillers regularly?

If you have painkillers, take them regularly as prescribed by your doctor. The aim is for pain control to be 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 painkillers are not helping, or if you get breakthrough pain. Depending on the type of painkiller you are taking, you may need to have your regular dose adjusted or be given a different painkiller. Remember that it can sometimes take time to get the right painkiller and dose.

Myself and the pain specialist worked out the medicines that I should have. Once you’ve balanced the number of pills and the correct amounts, it seems to work extremely well.

Sabrina


If I’m given a strong painkiller, does that mean that my cancer is advanced?

You may be given a strong painkiller, such as morphine, if you have severe pain. This doesn’t mean that the cancer is more serious. The dose can also be changed if the pain gets better or worse. If you have a strong painkiller, this doesn’t mean you will always need to take it. For example, if your pain improves, you may be able to take a milder painkiller.

On the cancer ward, they switched my husband to oxycodone. The doctors explained that this would help his pain. After a week or so he was able to walk again.

Joanne


Will I become addicted to painkillers?

Many people who are prescribed strong painkillers ask if they will get addicted to them, or if they will become confused and unable to look after themselves. This is unlikely to happen.

People who become addicted to drugs usually choose to take them at first, and then keep taking them because they can't stop. For example, they may crave feeling disconnected or 'high' when they take them. This is very different from someone who is in physical pain and needs to take the drug to control their pain.

Sometimes, the body can get 'used' to a painkiller so that more of the drug is needed to get the same level of pain control. This is called drug tolerance. If it happens, you will start to feel more pain. Your doctor or specialist nurse may need to increase the amount of painkiller you take, or give you a different type. Tolerance is very different to addiction.

Of course, you may feel more pain because the cancer is growing or for another reason. An increase in pain doesn’t always mean that you are tolerant to the painkillers you are taking.


What is the right dose of a strong painkiller?

Unlike many other drugs, there is no standard dose for morphine and some other strong painkillers. The right dose is the one that controls your pain, and this varies from person to person.


Is there a maximum dose for strong painkillers?

There is no maximum dose for some strong painkillers. If you take them as prescribed, you will not overdose. But suddenly increasing the dose is dangerous, so never increase the dose without talking to your doctor first.


Can I stop taking a strong painkiller?

If you are taking morphine or another strong 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. If they are stopped suddenly, you may get withdrawal effects. These include:

  • diarrhoea
  • cramping pains in the stomach and bowel
  • sickness
  • sweating
  • restlessness
  • agitation.


Can I drink alcohol if I’m taking painkillers?

This will depend on which painkillers you are taking. It is best to avoid alcohol if you’re taking opioid painkillers, such as morphine or codeine. This is because alcohol can increase side effects, such as drowsiness. It should be okay to drink alcohol with milder painkillers, such as paracetamol.

The painkillers will come with a patient information leaflet that has information about alcohol. You can also ask your doctor, nurse or pharmacist for more information about the painkillers you are taking.


Can I drive if I’m taking strong painkillers?

When you first start taking strong painkillers, they can sometimes make you feel tired and drowsy. You may not be able to concentrate and your reactions may be slow. If this happens, you should not drive or operate machinery.

It’s a good idea not to drive for at least five days when you first start taking strong painkillers, or if the dose has been increased. If you are not drowsy and feel able to drive after five days, you should be okay to drive. Keep your first drive short and easy, and take a driver with you in case you feel drowsy while you’re out.

Ask your GP for advice if you’re worried whether you’re safe to drive.


Will I be breaking the law if I drive while I am taking strong painkillers?

It is an offence to drive with certain drugs above certain limits in your body. This includes some prescription medicines. But most people taking strong painkillers will not be breaking the law as long as:

  • the painkillers are not affecting your ability to drive safely
  • the painkillers have been prescribed to treat a medical problem
  • you have followed the instructions you were given by the prescriber or the information that came with the painkillers.

The police can stop drivers and use tests to check whether they have taken any drugs. This may include a blood or urine test at the police station. So it’s a good idea to carry a copy of your prescription and the packaging the painkillers come in.

Remember, you are not breaking the law as long as you have taken the painkillers as they have been prescribed and are driving safely.

If you not sure you’re able to drive, you should not drive.

Your doctor, specialist nurse or pharmacist can give you more information about this.


Do I have to tell the DVLA, DVA or my insurance company?

You don’t have to tell the DVLA (or DVA in Northern Ireland) if you are taking strong painkillers – but they may need to know about your illness. Your doctor or specialist nurse can give you more information.

It is a good idea to tell your insurance company if your ability to drive may be affected. Each company is different, but your insurance may not be valid if you don’t tell them. Make sure you know what your doctor’s advice is before you phone your insurance company.