Think you’ll never need to face the decision to take an opioid? Consider that more than one in five people were prescribed an opioid painkiller at least once in 2015, according to one report. Also consider that the findings do not include people fighting cancer or suffering from terminal illnesses.

But you can protect yourself when faced with the decision to take an opioid for a legitimate health concern, says Judith A. Paice, Ph.D., R.N., director of the Cancer Pain Program in the Feinberg School of Medicine at Northwestern University.

Know the risk factors. All opioids have the potential to contribute to substance misuse, but it is important to realize that personal risk factors play an important role. “People who currently or formerly used substances (e.g., smoking, excessive alcohol intake or recreational drugs) are at risk, as are people who have a strong family history of substance misuse,” says Dr. Paice. “Additionally, experiencing sexual abuse or PTSD appears to be a strong risk factor for misuse of opioids and other substances.” Talk with your doctor about these factors if they pose a risk for you.

Ask questions until you’re satisfied. “When a doctor recommends using an opioid for pain management for yourself or a loved one, make sure to ask the following questions,” says Dr. Paice.

• Are there any alternative pain options that are safe for me?

• What is the lowest dosage that will be effective for me?

• How long will this treatment last?

• What type of side effects should I expect, and can some of these be prevented?

Stick to the med’s purpose. “It is essential to take the medication for pain—and only for pain control,” says Dr. Paice. “It is tempting to use the medication to help sleep or to treat anxiety, because these drugs do sedate and can cause a sense of relaxation.” But using opioids for these purposes can lead to problems, she warns. The sedating effects weaken over time, requiring higher and higher doses.

“There are better medications to assist with sleep, anxiety, depression, and other mood concerns,” says Dr. Paice. Be honest with your doctor about your physical, mental, and emotional symptoms so you can get the best treatment for you with the least risk.

Follow your doctor’s plan. Opioids are best weaned off slowly when the time comes. “When opioids are no longer indicated for pain control, we reduce the dose gradually to prevent withdrawal symptoms,” says Dr. Paice.

Speak up. If at any time, you’re uncomfortable with your opioid use or reaction to the medication, go straight to your doctor.