Opioids

What are opioids?

Opioids are strong medicines that treat pain. They can be taken by mouth, as an injection (shot), through a skin patch, or in a vein (IV). Common opioids include hydrocodone (Vicodin®), morphine, hydromorphone (Dilaudid®), oxycodone, fentanyl, and methadone.

Some opioid medicines are stronger than others. If your child’s doctor prescribes an opioid, follow all instructions to help your child use the medicine safely and effectively.

Opioids for pain management

Your child may have pain from illness, surgery, injury, or treatment. Doctors may prescribe opioids when pain is moderate to severe or when other pain medicines do not help.  

Opioids may not take all of the pain away. They do not work for all types of pain. Your care team may talk with you about types of pain and pain management options for your child. 

Possible side effects of opioid medicines 

Opioids can cause many side effects. These include: 

  • Sleepiness or feeling drowsy 
  • Nausea and vomiting
  • Itching 
  • Dizziness or feeling lightheaded 
  • Headache 
  • Dry mouth 
  • Confusion or problems thinking or concentrating 
  • Constipation (trouble pooping) 
  • Trouble urinating (peeing) 
  • Low blood pressure 
  • Slow or shallow breathing 
  • Harm to an unborn child 

 Opioids can have other potential risks or complications including: 

Opioids and pregnancy 

Opioids can harm an unborn baby. Taking opioids during pregnancy can cause the baby to be born dependent on opioids and may cause other health problems for the baby. 

If your child is sexually active, it is important that they take steps to avoid pregnancy while taking opioids. Patients should contact their doctor right away if they become pregnant while taking an opioid medicine. 

Deciding if opioids are right for your child 

Pain management is an important part of your child’s treatment. Pain that is not controlled can slow healing and recovery, interfere with sleep and daily activities, and cause stress. Opioid medicines can be an important tool in helping to treat moderate to severe pain effectively. Your care team will work with you to create a safe plan to manage your child’s pain. 

Pain management agreement 

If your child is prescribed opioids for pain, you might be asked to sign an informed consent form or pain management agreement. This helps the care team know that you understand the risks and benefits of opioids and will give them to your child as prescribed.  These steps help make sure that opioids are used safely. 

What should I watch for if my child takes opioids?

Your care team uses information from you to understand how well medicines and other pain management strategies are working for your child. Be ready to tell your care team: 

  • Is your child’s pain under control? 
  • Has your child had any side effects since they started the medicine? 
  • Is your child eating, drinking, sleeping, and going to the bathroom as expected?  
  • Do you notice any changes in your child’s mood, behavior, or ability to focus? 
  • Do you notice any signs that your child may be using the medicine in an unsafe way? 

Ways to monitor opioid use

Your care team may check how your child uses opioid medicines to help keep them safe. These checks may include: 

  • Pill counts: A team member may count pills to make sure your child is taking the right amount and that no pills are missing. 
  • Urine (pee) drug test: Urine tests can check for opioids and other substances to help make sure that medicines are used safely. 
  • Pain diary: You may be asked to keep track of when your child takes pain medicine, their pain level, pain triggers, and any side effects. 
  • Medicine checks at visits: Bring your child’s opioid medicines to doctor appointments. Staff might check the medicine and count the pills with you. 

Opioid addiction, dependence, and misuse

  1. Opioid addiction

    Addiction is an uncontrollable craving or use of a substance that can happen with certain types of medicines. Opioids have a risk of addiction because of how they work on the brain.   

    Opioids block pain signals between the body and the brain. They also release a chemical called dopamine. Dopamine can make people feel very good or “high.” Some people may want to feel that way again. This can lead to misuse. 

    Children and teens who take opioids before age 18 may have a higher risk of substance abuse or addiction later in life.  

  2. Opioid dependence

    When used to treat pain over a long period of time, opioids may cause physical dependence. Physical dependence is when the body starts to rely on the medicine. This can happen after a few days of taking opioids. Dependence is not the same as addiction.  

    Opioids can also cause tolerance, where a dose that worked before might not work as well.  

    Stopping opioids too fast can result in unwanted side effects. When it is time for your child to stop taking opioids, your care team will lower the dose slowly and safely. 

  3. Opioid misuse

    Opioid misuse means using the medicine in a way other than how it was prescribed. Parents and family caregivers can help keep opioid use safe.  

    Signs of misuse 

    Watch for changes in your child’s behavior or how they use their medicine. These changes may be signs of misuse:   

    • Taking a higher dose or taking medicine more often than prescribed 
    • Taking opioids with other medicines that the doctor did not prescribe 
    • Taking additional medicines or substances for pain 
    • Using opioid medicines for problems other than pain, such as to calm down or go to sleep 
    • Saying they want to feel “high” from the medicine 
    • Keeping or hiding extra opioid medicines or other drugs 
    • Doing fewer daily activities or not able to do their usual activities 
    • Telling you they are in pain when they do not seem to be 
    • Getting upset when talking about taking a lower dose or taking opioids less often 

    Changes that may mean your child is trying to get more medicine than they need include: 

    • Asking several doctors for opioid medicines 
    • Asking for medicines at an urgent care clinic or emergency department 
    • Calling the doctor’s office often for prescription refills 
    • Trying to get a prescription without making an appointment 
    • Saying the opioid medicines were lost or stolen 
    • Having fewer pills left than they should have 
    • Wanting to take opioids at a higher dose or for a longer time 

    Serious misuse can also involve Illegal or dangerous actions. These include: 

    • Using drugs or prescription medicines in secret 
    • Stealing or selling prescription drugs 
    • Getting opioid medicines from someone who is not a health care provider 
    • Faking or changing a prescription 

Risk factors for opioid misuse and addiction

Anyone who takes opioids can develop problems such as misuse, tolerance, or addiction. Your child’s risk may be higher if they: 

  • Are a teen or young adult  
  • Take opioids for a long time 
  • Take more than 1 type of opioid 
  • Have a personal or family history of alcohol or substance abuse 
  • Have problems at school, behavior concerns, mental health conditions (such as depression or anxiety), or a history of trauma or abuse 
  • Feel pressure from friends or peers to use substances 

Naloxone to reverse an opioid overdose

Naloxone (Narcan®) is a medicine that can save lives by reversing an opioid overdose when it is given quickly. It is often given as a spray or mist into the nose. 

Naloxone is safe to use in an emergency. It can be given even if you are not sure that someone has taken opioids. It does not work for other types of overdose. 

Patients and family caregivers can keep naloxone nasal spray on hand for use in an emergency. It is available by prescription and over-the-counter at retail pharmacies. 

Anyone who takes opioids can be at risk for an overdose. Your child may be at higher risk if they: 

  • Take opioids with benzodiazepines, such as Xanax® or Ativan® 
  • Have a history of overdose 
  • Have a history of substance use disorder 
  • Restart an opioid dose they have not taken recently 
  • Have sleep-disordered breathing 

How to store opioid medicines 

Always store opioids and other medicines out of reach of children. Keep them in a safe, lockbox, or locked cabinet when you can. Or put them where they are not easy for children to find. 

You might want to keep opioids with you when you are not home.  

How to dispose of unused opioid medicines 

Medsafe disposal box

Dispose of unused medicines safely by using a drug take-back box.

Do not save leftover opioid medicine. If your child needs pain medicine again in the future, the doctor can prescribe it at that time.  

Do not give opioid medicines to anyone else. This is against the law and could harm the person who takes them. 

If your child is enrolled in a clinical trial, ask your care team or pharmacist where to return the medicine. 

Dispose of unused opioid medicine by placing the medicine in a MedSafe™ or other medicine return box. These boxes are often found in hospitals, medical clinics, pharmacies, and police stations.

Take unused medicine to a drug take-back location in your community. Find more information or locate a public collection site.

If you need to throw away opioid medicines: 

  1. Take the medicine out of its original container. 
  2. Mix the medicine with used coffee grounds, used cat litter, or something else no one would want to eat.  
  3. Put the mixture in a sealed plastic container. 
  4. Throw it in your trash. 

If you have questions about opioids, talk to your child’s doctor, nurse, or pharmacist. 

Questions to ask your care team

  • Why do you recommend an opioid for my child’s pain? 
  • What dose should my child take, and how often? 
  • What are the most common side effects I should watch for? 
  • What side effects are an emergency or need quick attention? 
  • How can I tell if my child is using the medicine safely? 
  • How long will my child need to take an opioid medicine? 
  • Should we carry naloxone in case of an opioid emergency? 
  • Will you check pill counts or do other checks to make sure my child is using the medicine safely? 
  • Should we keep a pain diary? 
  • What is the safest way to store my child’s medicine at home? 
  • What should we do with unused medicine that my child does not need?

Key points about opioids for pain

  • Opioids are strong medicines that may be used to help manage pain as part of your child’s treatment plan. 
  • Opioids are usually used for moderate or severe pain or when other pain medicines do not help. 
  • Anyone who takes opioids can have side effects or other problems, including addiction, misuse, or dependence. 
  • Taking opioids exactly as prescribed helps lower the risk of side effects and misuse. 
  • Watch your child to make sure their pain is controlled and that they are using opioids safely. 
  • Take care to store and dispose of opioids and other medicines properly. 

Find more information

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Reviewed: April 2026

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