Pain Management VS American Opioid Crisis: Both Issues Matter

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For years now we have been hearing about the ever-present opioid crisis in America that has been devastating families and communities across the country. A surplus of surveys and statistics show just how prevalent this issue is. From rising overdose death rates to the economic impact of opioid abuse we can see how serious the problem has become. However, we also have to remember the importance of having pain management resources for those with real medical needs.

Every time we talk about the dangers of prescription opioids, there are those who feel their access to necessary pain medications is being threatened. So while we talk about the growing need for preventing opioid abuse, we also need to acknowledge those in pain who need relief.

Still, a lot of people who end up abusing opioids did not set out to get high. Many people are only trying to relieve pain. There is a connection between pain management and addiction, but how do we best address both effectively?

Over-prescription in America

One way you can see that over-prescription did contribute to the opioid crisis is that despite there being no change in the amount of pain Americans were suffering, prescription opioids still more than quadrupled between 1999 and 2012. Meanwhile, the rates of prescription misuse, opioid use disorder, and overdose also continued to rise at the same time.

In 2013, a quarter of a billion prescriptions were written for opioids—enough for every adult in the country to have their own bottle of painkillers.

Now many would argue that a large percentage of people who suffer from opioid use disorder are heroin users. This is true, but it is also fair to say that some heroin addictions began with using narcotic opioid medications, legally or illegally. Americans were made more vulnerable by the excess of prescription opioids available in the US.

For some time doctors were prescribing these medications with the best of intentions for treating pain. Something we must keep in mind, that many doctors in poorer areas also didn’t have access to as many alternative treatment options. Many were told for a long time that some of these drugs were not as highly addictive as we now know them to be. For years, drugs like Oxycontin were promoted to physicians as effective resources without dangers of addiction or withdrawal.

Thankfully, we know better today. Doctors and other medical professionals better understand the risks of opioids. And there has been a noticeable decline in prescriptions in the last 5 years.

Better Perspective on Prescriptions

According to a new report from the American Medical Association’s opioid task force, opioid prescriptions dropped 22% since 2013. The report notes there have also been decreasing in all 50 states. Experts believe this is an indication that health care professionals are being more conservative about prescribing opioids to patients.

One sign of progress against the opioid crisis- the number of healthcare professionals registered for prescription drug monitoring programs has more than tripled.

• 2014- 472,000 healthcare professionals
• 2017- 1.55 million healthcare professionals

Furthermore, the number of naloxone prescriptions had more than doubled. According to the task force:

• About 3,500 naloxone prescriptions per week in 2014
• Approximately 8,000 naloxone prescriptions per week on 2017

Judging from the data, it is safe to say getting prescription opioids is now harder than ever. Officials are paying very close attention to where these drugs are being used and how.

It is also safe to say that a lot of people who do need legitimate pain management have also felt that it is becoming harder for them to have access to the resources they need.

Minimizing Risks in Pain Management

For some people with severe pain, there may not be that many alternatives to pain management. Therefore, it is important that those who do need opioid treatment be ready to defend against the risk of abuse. Before starting any kind of opioid therapy, there are ways to minimize the risks of opioid misuse.

1. Talk to Your Doctor

Any time you are given a prescription, it is always best to have an honest conversation with the prescribing doctor, pharmacist, and/or your primary care physician. Make sure to get as much information as you can about possible side-effects and adverse interactions. The doctor should explain how the treatment plan will progress, and emphasize the importance of following the prescription.

Many doctors will automatically do this, but many others will not. Do not hesitate to ask for more information.

2. Don’t Use Someone Else’s Medications

Taking a medication prescribed to someone else can be dangerous, especially with opioids. Doctors typically factor in a lot about each individual and their symptoms before making a prescription. This means things like strength, dosage, and function are all accounted for based on the unique person. It also accounts for other medications one may be taking and how they interact. There are medications that can cause life-threatening effects when combined.

3. Do Not Self-Medicate

This goes with right along with number 2. It is not a good idea to decide on your own that you should be taking a powerful prescription narcotic. Likewise, it is not a good idea to make up reasons to take these drugs. Self-medicating is when you take an opioid:

– In any way different than prescribed

– To “feel better” when stressed or upset

– To get the feeling of euphoria or the “high”

Opioid painkillers are extremely addictive, so taking them to self-medicate only magnifies the risks.

4. Don’t Mix Medications

Opioid drugs are depressants that slow down the central nervous system (CNS). Because of this effect, overdosing can sow or even stop the respiratory system, with can cause coma or even death. So mixing a prescription opioid with another CNS depressant can have the same effect. If you are taking Xanax, and then take Oxycodone, these two medications put you at a very serious risk of fatal overdose.

Likewise, combining these drugs can also magnify the addictive properties of each substance. So mixing these powerful medications can actually make you more susceptible to developing an addiction.

5. Don’t Use for Long-Term

In most cases, opioid treatment plans aren’t intended for long-term use. As a means of pain management, many people will only use opioids for a limited time due to the risk of developing physical dependence or addiction. Sometimes, your doctor will prescribe opioid painkillers for long-term use. This is when it is up to you to decide whether you are comfortable with the risks associated with long-term use, or if you want to pursue alternative treatment options.

Alternatives to Pain Management

As we said, though opioids have a lot of issues associated with them, there is still a very real need for pain management. So many people who live with serious conditions or injuries do deserve a means of easing their suffering and make their lives more manageable. However, another way to avoid developing an issue with prescription drugs is by looking into alternative treatments for pain management.

One alternative is to take a biopsychosocial approach to pain management. These methods of treatment acknowledge the biological aspects of pain, while also acknowledging the social and psychological elements, and how they impact the experience of pain. This more holistic approach attempts to take the focus off of purely eliminating pain. Instead, it puts more effort into improving the quality of life and functioning.

Patients who take a biopsychosocial path to pain management learn coping mechanisms that allow them to return to healthy functioning, including taking part in:

• Social activities
• Work or vocational training
• Recreational activities

Here, patients are able to reduce pain levels by reducing depression, which can cause or exacerbate their physical symptoms of pain.

The Pain Recovery Program at Palm Partners tries to utilize a more holistic approach to pain management. Not only do we acknowledge the role of medications, but we also provide numerous opportunities for physical therapy and comprehensive addiction treatment. For some people, the hardest part of finding a new method of pain management is to get off of whatever opioid medications they are currently using. This is why safe medical detox can make such a big difference. When someone is struggling with physical dependence or opioid use disorder, it is important to remember that the right kind of foundation can make true lasting possible.

When it comes down to it, each individual should ask their doctor to examine the alternative options available. It is important that you are part of the process of deciding what is best for you. Pain management is important, but so is preventing substance abuse and addiction. We believe doctors should at least consider alternatives before turning to powerful prescription drugs. We should always take opioid addiction seriously. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.

Author: Justin Mckibben