Tackling Pain Without Opioids

Millions of people across the world suffer from pain. For some, pain is minimal or lasts only a short time while for others, pain is unbearable and chronic. Doctors have long prescribed opioids to help ease or reduce the perception of pain. When used properly and under a health care provider’s order, opioids can help. However, they can also cause side effects and be misused, which can lead to dependence and addiction.

In recent years, opioid medications (i.e. Hydrocodone, Oxycodone, Morphine, Codeine, and Fentanyl) have come under heavy scrutiny and gained national attention for heavy abuse and a large number of opioid-related deaths. “Opioid misuse is a national epidemic with no bias on the zip code it hits,” says Summit Medical Group New Jersey’s National VP of Pharmacy Services, Dr. Laura Balsamini. She adds, “In order to fully understand the severity of this epidemic, it’s critically important to understand how these pain medications impact the body.”

How do opioids work?

Opioid receptors are present in the brain, spinal cord, GI tract, and several other organs. Opioids attach to these receptors blocking the transference of pain signals. In addition, they also create feelings of calm or an intense rush of pleasure or a “high”, which is a feeling that can be very addictive. When naturally occurring opioids are not enough to stop pain, synthetic opioids, such as the ones mentioned above, may be prescribed by a doctor.
According to the Centers for Disease Control and Prevention, an average of 130 Americans die each day from an opioid overdose. “This is a true public health crisis,” says Dr. Balsamini. “One that requires both provider education on safe prescribing practices and patient education on the risks and dangers of opioids,” she adds.
The CDC created guidelines to help clinicians manage chronic pain, targeting safety and effectiveness of opioid therapy. These guidelines encourage providers to start with non-opioid medications (i.e. Tylenol or topical pain relievers) before prescribing opioids. Alternatives also include chiropractic medicine, physical therapy, massage therapy, meditation, or joint injections.
The CDC guidelines also target improving communication between providers and patients considering the risks and benefits of opioid treatment for each individual case of chronic pain. Additionally, the Prescription Drug Monitoring Program (PDMP) is an electronic, state-run database that allows providers to track the dispensing and prescribing of controlled medications. This program has proven to be one of the most promising interventions to inform providers and protect patients. Through this system, pharmacists and providers can more easily identify patients who are at risk for potential abuse.
Overall, when used as prescribed, opioids can be an effective way to treat intense and chronic pain. However, the recent increase in opioid abuse has established a significant need for stricter regulations.

If you have questions about pain relief or opioid use or abuse, speak to your provider. It’s never too late.


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