Long-Acting Opioids: Types, Side Effects, And Risks

Prescription opioids fall into two broad categories based on how quickly they take effect and how long they last, short-acting and long-acting. While short-acting opioids are typically prescribed for pain that comes and goes, long-acting opioids are designed for people dealing with chronic or persistent pain that requires around-the-clock management rather than on-demand relief.

Long-acting opioids, sometimes called extended-release or controlled-release formulations, are engineered to release the drug gradually over a longer period, providing more consistent pain control than repeated doses of short-acting medications. They are most commonly prescribed for conditions involving severe, ongoing pain such as cancer-related pain, advanced arthritis, or serious injury recovery, and come in tablet, capsule, and transdermal patch forms that can last anywhere from 12 hours to seven days depending on the specific medication.

What Are Long-Acting Opioids?

Long-acting opioids are prescription opioids that take longer to take effect but the effects of which last longer. Oftentimes you will hear this type of opioid medication referred to as an “extended-release” or “controlled release” version.

This type of opioid is generally prescribed for the management of moderate to severe long-term or chronic pain. It is usually administered on an around-the-clock basis to always keep the patient ahead of their pain.

Types Of Long-Acting Opioids

You will find long-acting opioids available in a few different forms, but the most common are tablets, capsules, or transdermal patches.

Long-acting opioids in capsule or tablet form tend to last at least 12 hours and up to 24 hours, while transdermal patches can last between three and seven days depending on the type.

Commonly prescribed long-acting opioids include:

• morphine (Kadian, MS Contin, Oramorph Sustained Release)
• oxycodone (OxyContin)
• oxymorphone (Opana Extended-Release)
• hydromorphone (Exalgo Extended-Release)
• methadone (Dolophine)
• fentanyl transdermal patch (Duragesic)
• buprenorphine transdermal patch (Butrans)

You may see the same prescription opioids available in both short-acting and long-acting versions. This gives physicians a choice when prescribing pain medication based on the type of pain and what would be best for the patient.

Side Effects Of Long-Acting Opioids

While long-acting opioids can be extremely useful when treating and managing severe pain, they do not come without some uncomfortable side effects.

Short-term side effects of long-acting opioids include:

• constipation
• trouble urinating
• fatigue
• nausea
• loss of appetite
• loss of interest in sex
• lightheadedness

Long-acting opioids also tend to be a top choice when treating chronic pain such as occurs with cancer patients, so it is important to be aware of long-term side effects as well.

Long-term side effects of long-acting opioids include:

• osteoporosis
• sleep apnea
• increased pain sensitivity
• low libido
• substance use disorders and addiction

Long-acting opioids do possess some very serious risks, but their medical benefits are still considered to outweigh any negative side effects.

Risks Of Long-Acting Opioids

Long-acting opioids tend to be abused less in general than short-acting opioids, but this does not mean that they come without risks. Like all opioids, they tend to create a sense of pleasurable euphoria that can be very addictive in nature.

When opioids are taken over an extended period of time, the body will start to produce less and less of its natural endogenous opioids, or endorphins.

Because of this, individuals may find themselves becoming dependent on their prescription opioids in order to feel normal.

Finding Addiction Treatment For Opioids

Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff