Risk of Overdosing

There is very little known about the risk of overdosing in patients receiving the drugs from their physicians for pain.

Among patients in a study, the cause of the overdoses varied. Medical records showed eight people accidentally took too much. Six were suicide attempts, while three had also obtained additional opioids from non-medical sources.

But in most cases, the reason for the overdose was unclear, including whether patients were taking the medications as intended when they overdosed, or if they had accidentally -- or intentionally -- taken more than was prescribed.

Symptoms of people who overdosed were delirium, loss of consciousness, confusion, respiratory problems and falling.

Because of the risks, physicians should closely monitor patients who are on long-term opioid therapy, prescribe as low a dose as possible to control pain and frequently re-evaluate whether the benefit of the drug is worth the risk.

"We need to consider what can be done to maintain the medical benefits of prescribed opiates -- you don't want to reduce appropriate availability -- while recognizing there are public health side effects," McLellan said.

Patient education and patient contracts, in which patients pledge to not share the drugs with others and to only use as necessary, have been shown to help, McLellan said.

"Patients must assume more responsibility for the storage and proper use of these medications, and doctors and dentists must recognize there are public health as well as individual patient implications," McLellan added.