Anabolic Steroids: What They Are, Uses, Side Effects & Risks

1 – Introduction

In March 2024 the Department of Health released its first‑ever National Public‑Health Briefing on Opioid Use Disorder (OUD).

The briefing is meant for every member of our community—whether you are a patient, caregiver, walo.vip teacher, employer or simply a neighbor who wants to help. It explains why OUD matters, how it can be prevented and treated, and what tools are available in Canada today.

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2 – What Is Opioid Use Disorder?

OUD is a chronic medical condition that involves the compulsive use of opioid drugs (prescription painkillers, heroin or synthetic opioids) despite harmful consequences.

Key facts:

Statistic	Detail
Prevalence	About 2 % of Canadians report problematic opioid use (Statistics Canada, 2021).
Age group most affected	25‑54 years old – 70 % of people with OUD are in this age range.
Gender	Men account for ~60 % of opioid-related deaths, but women have higher rates of opioid prescribing.
Geographic hotspots	Rural and remote regions (e.g., Northern Ontario, Yukon) see the highest overdose death rates.

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3. What is a "Prescription Opioid"?

A prescription opioid is a medication that contains an opioid agonist or partial agonist and is prescribed by a licensed health professional for pain management, cough suppression, or other therapeutic purposes.

Drug	Common Brand	Typical Indication	Typical Dose
Morphine	MS Contin, Kadian	Severe acute/chronic pain	30–60 mg orally q6h PRN
Oxycodone	OxyContin, Percocet	Moderate to severe pain	10–20 mg oral q8-12h
Hydrocodone	Vicodin, Norco	Moderate pain	5–10 mg oral q4-6h
Codeine	Tylenol #3	Mild-moderate pain; cough suppression	15–30 mg oral q4-6h
Fentanyl (patch)	Duragesic	Severe chronic pain	25–75 mcg/h transdermal

> Key points

> • Potency hierarchy: fentanyl ≫ morphine ≈ oxycodone ≈ hydrocodone ≈ codeine.

> • Equianalgesic tables (e.g., WHO, CDC) are used to convert between agents; always account for incomplete cross‑tolerance when switching drugs.

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2. Practical "How‑to" for an Opioid‑Naïve Patient

Step	Action	Rationale
1. Baseline assessment	Record pain intensity (0–10 VAS), location, functional impact; document comorbidities and medications.	Establishes a reference point and identifies contraindications.
2. Initiate first‑line therapy	If pain is mild/moderate (<5/10) or nociceptive, start acetaminophen 500 mg q6h PRN (max 4 g/day). If analgesic need persists, add NSAID if no contraindication.	Non‑opioid options are first choice; lower risk of adverse effects.
3. Escalate to low‑dose opioid	For moderate/severe pain (>5/10) or when non‑opioids insufficient: oxycodone 5 mg PO q4–6h PRN (max 40 mg/day). Begin with the lowest dose and titrate upward by 5 mg increments over days as needed.	Oxycodone has high potency; start low to minimize respiratory depression risk.
4. Monitor for side effects	Daily assessment of pain score, sedation level, respiratory rate (≥12/min), bowel function. If constipation occurs: lactulose 15 mL PO daily + increase fluid intake.
5. Escalation protocol	If pain remains >4/10 despite 3–5 days of oxycodone at maximum tolerated dose and side effects are manageable, consider adding a short‑acting opioid (e.g., hydromorphone 1 mg IV q6h PRN).
6. De-escalation plan	When pain improves to ≤2/10 for ≥48 h, taper oxycodone by 25% every 3–5 days while monitoring withdrawal symptoms.

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4️⃣ Alternative Pain‑Management Strategies

Strategy	How It Helps	Practical Tips
Non‑opioid analgesics (NSAIDs, acetaminophen)	Reduce inflammation and provide baseline pain relief.	Use NSAID with caution if renal function or GI risk is high; limit acetaminophen to <4 g/day.
Topical agents (lidocaine patches, diclofenac gel)	Provide localized analgesia with minimal systemic effects.	Apply patch on affected area 24 h before activity; check for skin irritation.
Cold therapy (ice packs, cold compresses)	Diminish inflammation and numb pain.	Use 15–20 min per session, avoid direct contact with skin to prevent frostbite.
Compression sleeves or elastic bandaging	Support microcirculation and reduce swelling.	Wear during activity; ensure not too tight to impair blood flow.
Low-level laser therapy (LLLT)	Stimulates tissue repair and reduces pain.	Typically administered by trained professionals; schedule weekly sessions if needed.

> ⚠️ Safety Note

> • Always monitor for signs of excessive swelling, discoloration, or numbness that may indicate impaired circulation.

> • Avoid over‑compression or prolonged use of tight garments.

> • Use compression or cooling only after the initial acute phase (first 24–48 h) unless advised otherwise by a healthcare professional.

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Quick Reference Table: Post‑Activity Management

Time After Activity	Recommended Action
< 30 min	Light stretching; stay hydrated.
30 min – 2 hrs	Rest; apply gentle compression if needed.
2–6 hrs	Ice (10–15 min) + light rest; avoid heat.
6–24 hrs	Continue icing as needed; monitor for swelling or pain.
> 24 hrs	Transition to warm showers or gentle massage if no inflammation remains.