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 will be in pain when you do not need to be.

Doctors use strong painkillers (such as morphine, an opioid), to treat severe pain from other causes as well as cancer. They sometimes use strong painkillers for moderate or mild pain.

Having morphine does not mean the cancer is more serious.

The important thing is that you have the right painkiller in the right dose to treat your pain.

If your pain improves, your doctor or specialist palliative care nurse may reduce the dose 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 have pain, do not increase the dose without talking to your doctor or specialist palliative care nurse first. Suddenly increasing the dose is dangerous. If you take your painkillers as prescribed, you will not overdose.

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 specialist 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 doctor 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.

Signs of withdrawal include:

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

• Make taking your medicines part of your daily routine – maybe by taking them after meals, depending on the instructions.
• Set an alarm on your mobile phone or computer to remind you.
• Write a note in a notebook that you keep nearby.
• Ask your partner, relative or friend to remind you to take them.
• Use a pain diary to help you keep track of when to take your drugs.

You may find it easier to have your drugs arranged in a blister pack or in a dosette box. These have separate compartments which clearly show the day and time when you should take your medicines. Your GP may be able to organise this with your pharmacist. You can also buy your own medicine container boxes (pill organisers) from most pharmacies.

It is important to store painkillers carefully.

• Check the date has not expired.
• Keep them in their original bottle or packet where you can clearly read the label.
• Keep them in a cool, dry place.
• Keep them out of sight and reach of children. 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.

If you are taking strong painkillers, you can usually drink small amounts of alcohol. This is around 1 or 2 units per day. Some people find it has a stronger effect on them and makes them feel unwell.

It may be best to avoid alcohol if you can.

Drinking alcohol with milder painkillers is not usually a problem.

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 increased.

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

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.

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

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