Given the lack of evidence that long-term opioids commonly reduce pain or improve the patient’s functioning or quality of life, the harms will often outweigh the benefits.
Common side effects of opioids include nausea, constipation, pruritus, sedation, dental caries, sexual dysfunction and low mood.5
Less common but serious side effects include falls, impaired ability to drive, overdose, respiratory depression, cardiac arrhythmias, exacerbation of sleep apnoea and death.5
Opioid use may also lead to dependence, withdrawal effects, opioid-induced hyperalgesia, tolerance and a range of personal and societal harms resulting from diversion of opioids.5
The balance of benefits and harms may change if the patient becomes more frail, the dose of opioids is increased, or if the patient takes sedative medication or consumes alcohol.