Common questions about painkillers

Start taking your painkillers as prescribed by your doctor, when you have pain. Sometimes people think they should delay using painkillers for as long as possible. But there is no need to delay taking them. If you wait until the pain gets really bad, it will be harder to get the pain under control. It also means you may be in pain when you do not need to be.

Having morphine does not mean the cancer is more serious. Doctors use strong painkillers (such as morphine) to treat severe pain from other causes as well as cancer. It is important that you have the right painkiller at the right dose to treat your pain. If your pain improves, your doctor or specialist palliative care nurse may reduce the dose of painkiller or change you to a milder painkiller. 

There is no maximum dose for strong painkillers. The right dose is the one that works for you. If you take your painkillers as prescribed, you will not overdose.

If you have pain, do not increase the dose without talking to your doctor or specialist palliative care nurse first. It can be dangerous to change your dose without guidance from your doctor or nurse.

Addiction is rare when a strong painkiller is used correctly to relieve cancer pain as prescribed by your doctor. If the painkiller is helping to relieve your pain, you are unlikely to become addicted to it.

If you are worried about becoming addicted, talk to your doctor or nurse. If your family and friends are also concerned, you could ask them to come to an appointment with you.

If your pain improves, you may be able to reduce and then stop taking a strong painkiller. But it is important that you do not suddenly stop taking it. Talk to your specialist palliative care nurse first. They will explain if it is a good idea to reduce your dose. They will also tell you how to do this gradually to avoid pain and withdrawal problems. Withdrawal is when your body finds it difficult to cope with suddenly stopping or reducing a drug that you have been taking.

Signs of withdrawal include:

• diarrhoea
• cramping pains in the stomach and bowel
• sickness
• sweating
• feeling restless or agitated.

Contact your doctor straight away if you have these symptoms.

Drinking alcohol with milder, non-opioid painkillers is not usually a problem. If you are taking strong painkillers, you can usually drink small amounts of alcohol. This is around 1 or 2 units (a small glass of wine) per day. But you may find it makes you sleepier. Some people find it has a stronger effect on them and makes them feel unwell. It may be best to not drink alcohol if you can.

Your painkillers will have a patient information leaflet. This will have information about alcohol. You can also ask your doctor, nurse or pharmacist for more information about the painkillers you are taking.

When you first start taking strong painkillers, they may make you feel tired and drowsy. You may not be able to concentrate, and your reactions may be slow. You may also be taking other drugs for pain which can make you drowsy and affect driving.

You should not drive or operate machinery for a few days:

• when you start taking strong painkillers
• if your dose of painkiller has been changed.

If you are not drowsy and you feel able to drive safely after this time has passed, you should usually be okay to drive. Do not drive immediately after taking an extra (breakthrough) dose of a strong painkiller.

Painkillers can affect people differently. It is your responsibility to judge if you feel safe and fit to drive. Avoid driving if you:

• feel sleepy or drowsy
• are struggling with co-ordination
• feel dizzy
• are having problems with your eyesight
• find it hard to concentrate due to the pain or as a side effect of the painkillers
• think you may be unable to do an emergency stop.

If you are not sure, speak to your cancer doctor, nurse, palliative care team or GP.

Keep your first drive short and easy. Take another driver with you in case you feel drowsy while you are out. If you are worried that you may not be safe to drive, ask your doctor for advice.

You do not have to tell the DVLA or the DVA in Northern Ireland if you are taking strong painkillers. But they may need to know about your cancer. 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 do not tell them. Make sure you know what your doctor’s advice is before you contact your insurance company.

It is an offence to drive with certain drugs above certain limits in your body. This includes some prescription medicines.

You may be prosecuted if you have drugs in your body that affect your driving, even if you have been prescribed the drugs.

You will not be breaking the law if the painkillers are not affecting your ability to drive safely, and you are:

• taking them exactly as your doctor prescribed them
• following the information that came with the painkillers.

The police can stop people who are driving and do tests to check whether they have taken any drugs. It is a good idea to keep a copy of your prescription with you, as well as the painkiller packaging.

If you are not sure whether you are able to drive, you should not drive. Your doctor, specialist nurse or pharmacist can tell you more about this.

Some countries limit the amount of particular drugs that can be taken into the country. There are restrictions about taking drugs like morphine into some countries.

We have more information about taking medicines abroad. 

Organising your medicines helps to make sure you store them all safely. It may also help you remember to take them exactly as your doctor prescribed.

Here are some tips for storing your medicines:

• Check the expiry date.
• Keep them in their original bottle or packet where you can clearly read the label.
• Keep them in a cool, dry place. Store them as directed by the leaflet inside.
• Keep them where children cannot see or reach them. You might want to lock away strong painkillers.

• Return any unused medicines to a pharmacy (chemist) so they can dispose of them properly. Do not put them in the bin or down the toilet.

It can be hard to remember to take your painkillers, especially if you have a lot of medicines to take. You may be taking more than 1 painkiller, as well as other medicines.

Here are some tips to help you remember when to take them:

• make taking your medicines part of your daily routine – for example, taking them after meals, depending on the instructions
• set an alarm on your mobile phone or computer to remind you
• write yourself a reminder
• ask your partner, relative or friend to remind you to take them
• use the pain diary to help you keep track of when to take your drugs.

If you are taking several different drugs, you may find it helpful to write down:

• the drugs you are taking
• what they are for
• their doses
• when you need to take them.

You may find it easier to arrange your drugs in a blister pack or dosette box. These have separate compartments which clearly show the day and time when you should take your medicines. These are made up by your pharmacist. Your GP may be able to organise this with your pharmacist. You can also ask your pharmacist for more information if you think this could help you.

If you have a smartphone there are free apps you can download to help you remember to take your medicines.