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Alternatives to Opioids: Everything You Need to Know

You may not feel like it, but pain is an important part of your body’s defense mechanisms. When something causes you pain, your nervous system is telling you that you need to do something to avoid damage. If you put your hand on a stove, pain helps you avoid getting a terrible burn by teaching you to pull away from danger quickly. However, pain can also be a problem when it persists after you begin to address the issue. Lingering pain can make it difficult to relax and sleep, which can impede your recovery process. Sometimes, you take your hand off the stove, treat it, and bandage it up, and you are still wincing in pain hours later.

Pain management is an important area of medicine that has been dominated by opioids for decades, and with good reason. Opioids are effective medications for treating pain caused by injuries, surgery, and chronic conditions. They are very similar to naturally occurring chemicals in the brain called endorphins. Opioids bind to receptors all over the body to stop pain signals from being sent to the brain. The problem with opioids is that they also have a profound effect on the reward center that can lead to substance use disorders. Repeated and prolonged use of an opioid can lead to chemical dependence and addiction.

When used as directed, most people won’t become addicted to opioids. However, because we rely on them so much, there is an overabundance of opioids in the United States. Doctors err on the side of caution and give patients more opioids than they will need, rather than risk having them run out and experience pain symptoms. Excess opioids are put in medicine cabinets where someone might pick them up, or they are given to friends or family, leading to abuse. Chronic pain is also an issue. People who experience long-term, ongoing pain symptoms need long-term solutions. Opioids are commonly used, but chronic opioid use is more likely to lead to dependence.

The opioid epidemic kills thousands of people every year because of prescription and illicit drug abuse. To alleviate this, doctors and researchers are turning to alternative therapies and medications and exploring new options to treat pain. There are a few options for people who are looking for opioid alternatives today, but a viable replacement for opioids has yet to be developed, though there are some possibilities on the horizon.

Here are a few available and emerging alternative to opioid pain-killers.

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Current Opioid Alternatives

Since pain is a serious problem in the world of medicine, there are a variety of medicinal options to treat it. Here are some common and emerging medications that can be used to treat pain symptoms.

Anti-Inflammatories

The most common pain relief options are anti-inflammatory medications. It’s likely that you have medication in this class in your home, backpack, or purse right now. Acetaminophen, ibuprofen, and aspirin all work to stop or reverse inflammation in the body that can be tied to pain. Inflammation is a common response to disease and injury as blood vessels burst, and the immune system starts to attack foreign invaders. For instance, when you get a cut and you notice that the edges of the cut are raised the next day, it’s because your immune system is attacking bacteria. Swollen tissue can also stimulate nerves which cause pain and discomfort. Anti-inflammatories relieve swelling, which can promote relaxation and healing.

However, not all pain is related to swelling, and sometimes anti-inflammatories aren’t strong enough to mask severe pain. Cancer, injuries, and surgery can cause severe pain because of exposed nerves, broken bones, and other factors. Anti-inflammatories can help, but it’s possible that you will still experience discomfort.  

Anticonvulsants

Chronic pain is often caused by problems with your nerves like peripheral neuropathy, herniated disks, and other forms of nerve damage. Nerve pain can come and go all the time, and in some cases, it can be difficult to live with. In such cases, anti-seizure medications and anticonvulsants can be helpful as a pain reliever. These medicines are intended to treat people who have epilepsy, but since they calm your nerves, they can be useful in treating pain that is caused by damaged nerves.

However, anticonvulsants like barbiturates and benzodiazepines can be powerful depressants that leave you feeling sedated and even sleepy. Other side effects include nausea, vomiting, double vision, loss of coordination, liver damage, drowsiness, and headaches. They can also be addictive, and they can cause dangerous withdrawal symptoms. Newer anticonvulsants like gabapentin and pregabalin may offer some of the same benefits with fewer risky side effects.

Cannabis

The medical use of cannabis is a controversial issue. It’s proponents often call it a miracle drug while people who are against it say that it has no place in medical use. Because marijuana is federally classified as a Schedule 1 drug, it can be difficult to conduct legal research on the drug, and there still aren’t many comprehensive medical marijuana studies. However, marijuana has been shown to treat nausea and vomiting symptoms in patients who are undergoing chemotherapy. There is also evidence that supports the usefulness in treating chronic pain, neuropathic pain, and multiple sclerosis symptoms with marijuana. However, the overall results of studies are mixed, and researchers have called for more studies to be done.

Non-Pharmacological Treatment Options

Some pain symptoms can be addressed without the use of medications. Though pharmacological options are often the best choice for severe pain, the following therapies can help supplement medicines and help deal with the psychological factors that lead to pain.

Physical Therapy

Pain can worsen over time because of changes in posture, muscle atrophy, and uneven wear and tear. Chronic pain can cause people to compensate for natural motions and positions that become uncomfortable. Physical therapy and exercise therapy can help correct those issues by strengthening muscles, improving your posture, and other issues that can contribute to pain. Exercise can also improve your overall health and well-being by improving cardiovascular health, strengthening your core muscles, and improving your mental health. It has also shown to reduce pain symptoms immediately after exercise, and consistent exercise can produce long-term improvements.

However, some people are limited in their ability to do exercise because of existing conditions that are causing their pain symptoms. Plus, without supervision or expert guidance, certain exercises can worsen joint pain.

Cognitive Behavioral Therapy

Psychological factors can also cause or worsen pain symptoms. Anxiety and stress can even cause symptoms like chest pains in otherwise healthy people. Cognitive behavioral therapy (CBT) is a popular treatment option in the addiction treatment world, but it also can help alleviate pain symptoms associated with psychological factors. CBT can also help people develop positive coping strategies when it comes to dealing with chronic issues. However, CBT isn’t useful in treating pain caused by serious physical injuries and disease, but it can be a helpful supplementary treatment.

Sources

Hill, K. P. (2015, June 23). Medical Marijuana for Treatment of Chronic Pain and Other Problems. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/2338266

Kroll, H. R. (2015, May). Exercise therapy for chronic pain. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25952064

Mayo Clinic. (2016, September 08). Anti-seizure medications: Relief from nerve pain. Retrieved from https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/in-depth/pain-medications/art-20045004

National Institute on Drug Abuse. (2018, July). FAQs About Opioids. Retrieved from https://www.drugabuse.gov/publications/opioid-facts-teens/faqs-about-opioids

National Institute on Drug Abuse. (2018, January). Behavioral Therapies. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies

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