CDC issues opioid prescribing guidelines. Read More 

Opioids are the most powerful known pain relievers and have brought relief to millions of people who are healing from musculoskeletal injuries, recovering from surgery, or coping with cancer. Yet even when used as prescribed, opioids are associated with sedation, respiratory depression, and other serious adverse events.

Opioid adverse effects are common

Other common adverse effects of opioids include nausea, vomiting, constipation, falls, hypotension, hallucinations, delirium, and aspiration pneumonia. Adverse effects can occur in patients receiving any opioid drug, including fentanyl, hydrocodone, oxycodone, hydromorphone, morphine, and methadone.

In the inpatient setting, opioids are among the drugs most frequently associated with adverse reactions. In one large study, opioids were responsible for 16 percent of drug-related adverse effects.1 A study of post-surgical patients found that almost 14 percent of those who received opioids experienced an adverse event.2 The study also found that the risk of death while hospitalized was more than three times higher among the patients who experienced an adverse effect associated with opioids compared with patients who did not. (For more information, visit our section on inpatient risks for additional information.)

Opioid misuse in community and outpatient settings

In the community or outpatient setting opioid misuse has become a significant health threat in the US. Non-medical use of these drugs has increased dramatically in recent years, with a corresponding increase in overdoses and death. According to the Centers for Disease Control and Prevention, more people die from opioid overdoses in the US now than from cocaine or heroin overdose. (For more information, visit our section on risks in community and outpatient setting.)


For more information about opioids risks and adverse events, download the Premier Safety Institute’s review: Opioid analgesics: a double threat to patient safety.


  1. Davies EC, Green CF, Taylor S, Williamson PR, Mottram DR, Pirmohamed M. Adverse drug reactions in hospital in-patients: a prospective analysis of 3695
    patient-episodes. PLoS One. 2009;4(2):e4439.
  2. Kessler ER1, Shah M, Gruschkus SK, Raju A. Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from
    a large health system: opioid-related adverse events and their impact on clinical and economic outcomes.
    Pharmacotherapy. 2013;33(4):383-91.