Opioids have side effects which can limit their acceptability to patients.
Patients should be reassured that most opioid side effects (constipation, nausea, sedation, pruritus, urinary retention) are short-lived or otherwise manageable, and they should seek help immediately for intolerable side effects.
Opioids can slow reaction time, cause drowsiness, or cloud judgment when they are first started or increased. Most experts agree that driving or operating heavy machinery is unsafe and should be avoided until a stable dose has been reached.
Multiple studies suggest that many patients on chronic opioids (defined as no dose change within the last week) have no increased risk of motor vehicle collisions compared to the general population and no reduction in concentration or perception compared to controls.
Counseling bottom line: patients who have been on a stable dose for a week, who feel no cognitive changes (drowsiness, ‘fuzziness,’ difficulties in concentrating) can drive.