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What Does It Mean to Be Opioid Naïve?

Table of Contents

Opioid naïve is a term used to describe an individual who has not used opioids consistently.

Opioid-naïve individuals have larger reactions to opioids because their bodies are not used to them. If you are opioid naïve, you may experience stronger side effects to opioid drugs compared to someone who takes opioids regularly or consistently.

What is Opiod-Naive

Dangers of Opiate Use in Opioid-Naïve People 

There are times in life when individuals who do not normally take opioids may need to do so: for example, after a dental or surgical procedure, or acutely after an accident to treat pain. While it is generally safe to take opioids for a few days, there are always risks, even with short term use.

Below are some risks of opioid use in someone that is using opioids for the first time:

Opioid Side Effects

Short term use of opioid still has some unpleasant side effects including itching, rashes, constipation, nausea/vomiting, and sedation/sleepiness. 

Opioid Use Disorder (OUD)

Opioids are powerful medications that release feel-good chemicals inside your brain and body. Even short term use of opioids can put someone at risk for developing a dependence on opioids, particularly if they have a strong family history of addiction or dependency.[1] 

In one study, each refill of an opioid was associated with an increase risk of misuse of 44%.[2]Every day, about a thousand people visit American emergency rooms due to the misuse of opioids.[4]

Risk of Overdose 


Opioids are central nervous system depressants. Take too much, and you'll sedate critical functions like breathing. Overdose risks with opioids are very high, especially for people who are opioid naive. These risks can be even higher if you are elderly, have other medical conditions, or any underlying breathing problems.

What to Do If You Are Using An Opioid For The First Time

Short term use of opioids for acute pain is generally safe, but does always carry risks, even for short term use.

If you've never used opioids before, have a conversation with your doctor prior to using opioids, either short or long term.

Discuss other methods of pain control. If no alternatives are available, manage your prescription very carefully and stop taking the pills as soon as you no longer need them. If you are having trouble discontinuing your opioid use after recently starting a new prescription, take to your doctor right away.

Sources

  1. Prescription of Opioids for Acute Pain in Opioid Naïve Patients. UpToDate. https://www.uptodate.com/contents/prescription-of-opioids-for-acute-pain-in-opioid-naive-patients. May 2022. Accessed July 2022.
  2. Postsurgical Prescriptions for Opioid Naïve Patients and Association with Overdose and Misuse: Retrospective Cohort Study. BMJ. https://www.bmj.com/content/360/bmj.j5790. December 2017. Accessed July 2022.
  3. Opioid Prescribing in Naïve or Tolerant Patients. Drugs and Therapy Bulletin. https://professionals.ufhealth.org/files/2011/11/0312-drugs-therapy-bulletin.pdf. March 2012. Accessed July 2022.
  4. Opioid Overdose. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK470415/. May 2022. Accessed July 2022.
  5. Loss of Tolerance and Overdose Mortality After Inpatient Opiate Detoxification: Follow Up Study. BMJ. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC153851/. May 2003. Accessed July 2022.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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