Delivering Pain Medicine

You don’t have to accept pain as a normal part of having cancer or getting cancer treatment. There are many different medicines available to help control pain. There are also many ways to take pain medicines. For instance, you may use pills, patches, or a special pump. As your pain changes, the medicines you need and the way you take them may change as well. You may find that nonmedicine methods may also help you manage your pain. These include relaxation, message, and biofeedback.

Your healthcare provider will work with you to find the best pain management plan for you. This information can help you understand some of the ways you can use pain medicines safely and effectively.

How are pain medicines given?

Pills, tablets, and sprays

Taking pain medicines by mouth is the most common way medicines are used to treat cancer pain. Some medicines are swallowed as pills or liquids. Others are allowed to dissolve in your mouth. Some medicines can be taken as a mouth spray or nasal spray.  

Patches and suppositories

If you can't take medicines by mouth, a patch that sticks to the skin can give you medicine over a few days. Some medicines, called suppositories, are placed and absorbed in the rectum.

IVs and PCA pumps

With IV (intravenous) delivery, a small tube (catheter) sends medicines into a vein in your hand or forearm. With a PCA (patient-controlled analgesia) pump, you push a button to receive a dose of pain medicine. In some cases, a pump is used to deliver pain medicine continuously. This means you don't need to push a button. In either case, the pumps are carefully set so that you can only get a certain amount of medicine over a certain amount of time.

Shots

In some cases, shots (injections) are used to treat pain in certain areas. For instance, a steroid injection into a joint can decrease inflammation and joint pain. In some cases, local anesthetic medicine is injected into nerves. This is called a nerve block.

Spinal and epidural anesthesia

Spinal and epidural anesthesia are sometimes used to control severe pain. Medicines are delivered near or directly into the fluid that surrounds the spinal cord (cerebrospinal fluid). These methods (epidural or spinal) block pain in 1 section of the body, often from the waist down.

Will I become addicted?

Addiction is a common concern for people who have to use strong pain medicines (called opioids or narcotics) to treat cancer-related pain. In fact, this fear may keep some people from getting the pain control they need. Pain medicine can be safely used to treat cancer pain. When taking pain medicines, it is important to work closely with your healthcare provider. Take medicines only as instructed.

Taking medicines as prescribed to relieve pain will not cause addiction. It's important to know that, over time, some people need higher doses of medicine to get pain relief. This is not addiction. It is tolerance, which means your body has adjusted to the dose you've been taking so it doesn't work as well as it once did. Again, work with your healthcare provider to take your pain medicines safely and correctly. This helps keep addiction from becoming a problem, and helps you get the pain control you need.

Always keep your pain medicines in a safe place. Never share your pain medicines with anyone. Be aware that some people might try to steal your opioid pain medicines and sell them illegally.

Talk with your healthcare provider

Talk with your healthcare provider about your pain and how it affects your life. To ensure good, safe pain control, be sure to:

• Understand the correct doses and how and when to take your pain medicines.

• Not crush or break pills unless your provider or pharmacist says it's OK.

• Ask about the side effects of your pain medicine and what can be done to prevent or control them.

• Know that you may need to try different medicines, different ways to take them, or different combinations of medicines to get the best results.

• Make sure that all your providers know about all the medicines you take, but only 1 provider gives you pain medicines.

• Ask your provider or pharmacist how to get rid of your pain medicines safely when you stop using them.

• Not wait to take your medicine until pain gets bad.

• Not suddenly stop taking all your pain medicines. You may need to reduce the dose slowly, so talk to your provider about this.

• Not run out of pain medicine. Try to always have a 1 week supply. You may need written prescriptions or extra time to order certain kinds of medicines.

• Never share your pain medicines with anyone.

• Store your medicines in a safe place so they can’t be stolen. If you think your medicine has been stolen or lost, tell your healthcare provider right away.

When to call your healthcare provider

Talk with your healthcare provider or nurse about side effects or problems you should watch for while taking pain medicines. Also be sure you know when you need to call them. For instance, you may need to call your provider if:

• Your pain medicines aren't working

• You can't take your pain medicines as prescribed

• You have severe side effects like breathing problems, trouble waking up, dizziness, confusion, or severe constipation