Downloads & Leaflets
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- Access Standards - what to expect from your surgery
- Digital Buddies - can you help others?
- Digital Buddies - Do you require help?
- PHQ-9 questionnaire (depression screening) online via Patient.info. This will open in a new tab
- Macmillan We're Here to Help - English.pdf
- Macmillan We're Here to Help - welsh.pdf
- Macmillan - signs and symptoms of Cancer
- Mental Wellbeing Support
- Macmillan Telephone Buddies - English
- Macmillan Telephone Buddies - Welsh
- NEWCIS Services - Bilingual
- Rhyl City Strategy - Information leaflet - English
- Rhyl City Strategy - Information leaflet - Welsh
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Strong Opioids
Opioids – Patient Information
Opioids are strong pain-relieving medicines, sometimes called “morphine-type” medicines. They work in a similar way to the body’s natural painkillers.
They are used to treat moderate to severe pain when other medicines, such as paracetamol, are not strong enough. They may be prescribed after surgery, injury or a heart attack, and for conditions such as cancer, heart failure, or lung and liver disease. Low doses can also help with breathlessness or cough.
Common opioids include codeine, tramadol, morphine, oxycodone, fentanyl and buprenorphine. They are available as tablets, liquids, patches or injections.
Opioids can improve comfort and help you carry out daily activities. However, they may not take pain away completely, and other treatments may also be needed.
If you have any questions or concerns about your medication, please speak to your pharmacist.
There is no standard opioid dose. The amount needed to control pain varies from person to person. Opioids are usually started at a low dose and gradually increased (titrated) until the right level of pain relief is reached.
Most people are started on morphine. If this does not suit them, another opioid, such as oxycodone, may be used instead.
Long-acting and short-acting opioids
Strong opioids are often prescribed in two forms:
Long-acting (modified release, MR)
Taken regularly to control background pain.
Usually tablets or capsules taken twice daily (every 12 hours).
Work by releasing the medicine slowly into the bloodstream over many hours.
Short-acting (immediate release, IR)
Used as needed for sudden or “breakthrough” pain.
Usually liquid or tablets.
Start working within 20–30 minutes and last about 3–4 hours.
May sometimes be given by injection in certain situations.
Short-acting opioids may be used regularly at first to find the correct dose, before changing to a long-acting preparation.
Skin patches
Opioid patches (such as fentanyl or buprenorphine) release medicine slowly through the skin over several days.
They can be helpful for people who:
Cannot swallow tablets
Prefer not to take medicines by mouth
Have kidney problems
Patches are usually changed once or twice a week. Because they release medicine slowly, they do not work immediately when first applied.
Your specialist will advise you how and when to take your medication.
Possible Side Effects of Opioids
Constipation
Constipation affects most people taking opioids. You will usually need to take a regular laxative, such as 1–2 senna tablets at night. Your doctor or nurse will advise you.Nausea (feeling sick)
Some people feel sick when they first start opioids. This usually settles after a few days. Anti-sickness medication can be prescribed if needed.Dry mouth
This can be helped by:Taking frequent sips of drinks (at room temperature)
Sugar-free chewing gum
Good mouth care
Artificial saliva gels or sprays are available and can be prescribed.
Drowsiness
Feeling sleepy can happen when starting opioids or after a dose increase. This usually improves within a few days. Opioids may help restore normal sleep at night, but they should not cause ongoing daytime drowsiness.If side effects continue or concern you, speak to your doctor, nurse or pharmacist.
Less Common but Important Side Effects
Contact your doctor or nurse promptly if you experience:
Persistent drowsiness or difficulty concentrating
Bad dreams
Hallucinations
Confusion
Muscle twitching
Itching
Difficulty passing urine
If these side effects occur, your dose may need to be reduced or you may need to change to a different opioid.
Do not stop your medication suddenly without medical advice.
Ongoing Monitoring
If you take opioids or other pain medicines for more than a few weeks, you will need regular reviews with your GP or specialist team. This helps ensure the medication is still working well and not causing problems.
Your pharmacist can also provide advice and support.
You may receive an initial supply of medication from the hospital, but repeat prescriptions are usually provided by your GP.