Chronic Pain Management: How to Manage Pain Without Opioids

You may ask yourself, why is it so important to find alternatives to opioid medications to treat chronic pain? We are living in a time where opioids have claimed hundreds of thousands of lives and continues to decimate an already weakened society. According to the U.S. Centers for Disease Control and Prevention (CDC) reports that the majority of drug overdose deaths involve an opioid. In 2015, there were enough opiates prescribed for American citizens to be medicated around-the-clock for three weeks.

The most recent statistics released by the National Institute for Drug Abuse (NIDA) show that 130 people a day are dying from opioid overdoses. The misuse of opioids, which include prescription pain relievers, is a severe national crisis that affects those not addicted to drugs. Studies have shown that 80 percent of heroin user’s got started with prescription opiates, which is a problem that doesn’t look as though it’s going to change any time soon.

Unfortunately, we live in a world where chronic pain is prevalent. The CDC estimates that 20.4 percent of adults in the United States had constant pain, and another eight percent had high-impact chronic pain. In some cases, opioid-treatment is the best option for those living in pain. Many individuals function highly and can manage their pain with these drugs responsibly. 

However, there is another portion of the population that will misuse their prescriptions to the point of addiction. There is no way to determine if someone will become addicted to opioids, and that has put pressure on scientists to develop alternative medications that alleviate some of their worst symptoms. Chronic pain sufferers will be the first to admit their disdain toward using powerful narcotics, but many will argue that they’d much rather function normally in life utilizing the medication than without.

When Did Opioid Use Spiral Out of Control?

Humans have been using opioids for thousands of years. We have seen a fair share of opium crises in the past, but nothing can compare to what our country is currently facing. Twenty years ago, it was more common to prescribe opioids to treat opioids to treat mild pain. The painkillers were intended for moderate to severe acute or chronic pain, but a shift in culture allowed for narcotic drugs to be used for pain that Advil or Tylenol could alleviate. 

Physicians were misinformed and believed addiction to the medications was highly unlikely.

The addictive properties of opioids were not fully-recognized, at the time. Thus, a new chapter in our history was born. Opioid use exploded, pill mills were created, and it felt like we were on the brink of a collapsing society. The government stepped in and placed harsh restrictions on prescription opioids, but the damage had already been done.

Today, we are fully aware of the serious and potentially fatal risks of opioids. What is being done to curb opioid use?

The Challenges of Pain Management

You and your primary care physician or pain management doctor may find managing chronic pain to be stressful. Many reports highlight insufficient training on the topic of opioid prescribing. 

The CDC notes that the process is challenging for healthcare providers as well as their patients. To provide adequate multidimensional treatment, a patient must consider all options for treating their ailments. Doctors and patients must consider the benefits and risks of all treatment options.

Patient-Centered Approach to Treatment Without Opioids

To encourage a patient on their journey to managing their chronic pain, they must implement specific strategies. Some of these include:

• Setting reasonable goals: Speak with your doctor about what you are trying to achieve. Tell them your level of pain and focus on goals related to daily activities or function that you’d like to accomplish. In some cases, eliminating pain is not a realistic goal, and setting your expectations may garner a better outcome.
• Have an open mind: Voice your concerns. Be ready to accept recommendations from the doctor that you may have been resistant to in the past. Remember, doctors are empathetic people who want to make sure you get the proper treatment. 
• Non-opioid medications: Many people go into the doctor and expect narcotics right off the bat to treat their pain. Look at opioids as a last resort and try other options first.
• Cognitive-behavioral therapy: CBT addresses psychosocial contributors to pain, which includes fear, distress, avoidance, and anxiety. It allows patients to improve their function, and it trains people in behavioral techniques to help their body process the pain. CBT promotes patients to be active and will provide them with relaxation techniques and coping strategies.
• Exercise therapy: While this may not be for everyone, exercise therapy can massively reduce some symptoms of chronic pain. Exercise can improve well-being and physical functioning, and treatment effects can last for three to six months. The effectiveness of this approach is higher in populations that visit a healthcare provider compared versus the general population.

Non-opioid considerations

Analgesic medications, such as acetaminophen, can be helpful in treating lower back pain, migraines, and osteoarthritis. Anticonvulsant medications, such as gabapentin and pregabalin, can be useful medications in treating diabetic neuropathy, neuropathic pain, fibromyalgia, and postherpetic neuralgia. In some cases, antidepressants are utilized to treat pain. Certain SSRI drugs can help neuropathic pain, migraines, and diabetic neuropathy. 

Conclusion

At the end of the day, you know what the right approach for you is. Only you can decide what helps manage your chronic pain, but considering alternative medication may benefit you long-term. 

Now that enough data has been published to highlight the addictive nature of opioids; many people are seeking a different approach to their suffering. If you are struggling with chronic pain or addiction, you must speak with your doctor to determine the best path for you. Pain can cause suicidal thoughts or feelings of hopelessness. If you are feeling this way, please get help immediately.

Sources

National Institute on Drug Abuse. (2019, February 12). A Promising Alternative to Opioid Pain Medications. Retrieved from https://www.drugabuse.gov/news-events/nida-notes/2019/02/promising-alternative-to-opioid-pain-medications

Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults – United States, 2016 | MMWR. (n.d.). Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm

National Institute on Drug Abuse. (n.d.). Prescription opioid use is a risk factor for heroin use. Retrieved from https://www.drugabuse.gov/publications/research-reports/relationship-between-prescription-drug-heroin-abuse/prescription-opioid-use-risk-factor-heroin-use

National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

Module 2: Treating Chronic Pain without Opioids. (n.d.). Retrieved from https://www.cdc.gov/drugoverdose/training/nonopioid/508c/index.html