Opioids can be a sensitive topic to discuss with your patients. However, addressing safe use of these medications is important for your patients. Use these practices to guide your discussion.
Opioid counseling checklist
When discussing opioids with your patient, include these topics:
- Indication for the medication
- Administration instructions
- How often the medication should be taken
- Side effects to expect from the medication
- Proper steps for discontinuing the medication
- Proper storage and disposal of the medication
Counseling best practices
When discussing opioid use with your patient, remember to:
- Use active listening
- Be empathetic
- Make yourself available
- Ask open-ended questions
- Avoid stigmas and refrain from using the term “addict”
- Use written and verbal communication
Ease into the conversation with questions like:
- What medications have you taken to manage your pain? How did you respond to those medications?
- How well is your medication controlling your pain?
- What side effects, if any, are you experiencing from your pain medications?
- Besides medications, what other ways are you managing your pain?
- Are you aware of medications you should avoid while taking opioids?
Reminders for safe storage and disposal
Share tips for keeping opioid medications safely stored:
- Store out of plain sight
- Keep out of the reach of children and pets
- Consider a lock box
- Dispose of unused medication properly
- Take unused medication to the local police station or disposal site; check dea.gov for a site near you
- Reference disposal instructions at fda.gov
Corresponding responsibility best practices
Per federal regulation, although responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, a corresponding responsibility rests with the pharmacist who fills the prescription.
- Look for “red flags” suggesting abuse or misuse
- Check the Prescription Drug Monitoring Program and fill history as necessary
- Contact the prescriber with any concerns
- Dispense naloxone as needed and counsel appropriately
Naloxone FAQs
| Question | Answer |
| How quickly does naloxone work? | Naloxone works within 2-5 minutes, depending on the route of administration. |
| What are the side effects of naloxone? | Naloxone may cause opioid withdrawal symptoms such as agitation, sweating, nausea, vomiting or tremors. |
| Where should I store naloxone? | Naloxone should be stored in the original package at room temperature, avoiding light exposure. |
| What is the shelf-life of naloxone? | Naloxone’s typical shelf-life is 12-18 months. |
| What dosage forms does naloxone come in? | Naloxone is available as an intranasal kit, an intramuscular kit and an intramuscular auto-injector. |
| When should naloxone be administered? | Naloxone should be administered at the first sign of overdose – when the individual’s breathing has slowed or stopped. |
| What should I do after administering naloxone? | Call 911; report if the individual is unresponsive. If necessary, begin rescue breathing: pinch nose, tilt head back and provide two slow rescue breaths into mouth. Follow up with one breath every five seconds |
| How long does Naloxone last? | Naloxone’s duration of action is 30-90 minutes, so patients can slip back into overdose if long-acting opioids were taken. |
Naloxone conversation starters
- “Opioids can have a range of side effects including slowing down or even stopping breathing. Naloxone can help in this case of emergency by restoring breathing.”
- “Having naloxone is like having a fire extinguisher. It’s almost never used, but it is there when you or a family member may need it.”
- “Anyone using an opioid is at risk for an accidental overdose. This is simply a safety measure.”