Doctor O'ConnorThe UVA Emergency Department’s Dr. O’Conner, MD, MPH, shares tactics for broaching the topic of opioids with friends and family.

Start with an Ice Breaker

An icebreaker is something that is done or said to get through the first difficulties in starting a conversation or discussion. Icebreakers get people talking, lessen inhibitions, and breaks an awkward silence. Icebreakers are especially useful in starting conversations around difficult or painful topics, such as opioid addiction.

Raise your hand if…

I was recently at a conference where one of the speakers planned to talk about the opioid crisis. To break the ice, the speaker asked those who have a good friend or family member suffering from chronic pain to please raise their hand. About one-third of the hands went up. He then asked those who have a good friend or family member who abuses opioids to please raise their hand. About one-half of the hands went up. He then asked those who knew someone who died from an opioid overdose to please raise their hand. Again, about one-half of the hands went up.

When he asked a group of high school seniors the same question, every hand in the room went up. Every hand. Every high school senior in the room knew someone who had died of an overdose! While we may be reluctant to talk about how this affects us personally, the fact that every student in the room was affected by the problem shows its ubiquity and devastation.

Prescription Experience and Usage

My icebreaker is to ask people if they have ever been prescribed an opioid. This would be common after procedures such as wisdom tooth extraction, or after an injury. If they say yes (most do), I then ask if the drug worked. Most people tell me they took one or two doses and stopped because it made them feel terrible.

Be Aware of Proper Dosage and Pill Disposal

Prescriptions are commonly written for 30 pills which may leave 28 unaccounted for. Few can recall what happened to the remaining pills. Thinking back to the group of high school seniors, it is likely that these pills found their way into the hands of someone with an opioid use disorder, and the pills weren’t even missed.

In my own practice, I limit the number of doses that are prescribed to about 10 or 15 doses – enough for the first several days. This accomplishes several goals. The patient has enough doses of pain medications to treat their pain during the acute phase following initial treatment. It also encourages them to follow-up with another specialist in the event that pain persists beyond the initial several days. Persistent pain may indicate the need for additional treatment or may be a symptom of serious complications. Limiting the number also encourages the treatment team to find effective alternatives in pain management.

Safely dispose of opioid prescriptions and unused medications in the medications receptacle at UVA Pharmacy or other approved site.

Have A Candid Conversation

In order to confront the opioid crisis, it is imperative that each of us be aware of how the problem could affect us personally. The following are some recommendations for addressing this problem with friends and family.

  • Keep track of all prescriptions that come into your home.
  • Take medications only as directed.
  • Try non-opioid methods of pain control in consultation with your physician.
  • Dispose all unused medications when they are no longer needed.
  • Monitor use by family members who are prescribed opioids.

Break the ice and have candid conversations with friends and family members. Misuse of opioids is not a rare occurrence, and by maintaining caution and vigilance, we can save a life.

If you are seeking treatment for yourself or someone else, contact Region Ten at 434-972-1800 or if someone is in immediate danger, call 911 for emergency services. The Blue Ridge Poison Center, located at the UVA Health System and staffed by Emergency Medicine personnel, can answer questions regarding medication mistakes and the consumption of other substances–the center can be reached at 1-800-222-1222.