It is hard to put the genie back in the bottle. So too, with the opioid epidemic.
Opioids used to be mostly prescribed for short-term acute pain or cancer patients. Then the big pharmaceutical companies lobbied hard for their newer, supposedly “safer” opioids to be prescribed more freely, including for chronic pain, which persists for months or years.
This was a disaster waiting to happen because even short-term opioid use can lead to addiction. The danger of addiction is even greater when there is no limit on how long or how many opioids are prescribed. Belatedly, the governments (local and national) tried to stop the overprescription.
Opioids don’t even work that well for most kinds of pain. The patient develops tolerance too quickly, requiring ever higher doses to control the pain. Eventually, they stop working but the patient remains addicted.
Unfortunately, once people became addicted to prescription opioids, preventing them from refilling their prescriptions failed to halt the epidemic. Rather than stop and suffer withdrawal pains, many switched to other, deadlier illicit opioids such as heroin and fentanyl.
Worse, because these black market drugs are not legal and regulated pharmaceuticals, there is no quality control. There’s no telling if they are adulterated or how potent they are. Many more people are overdosing and dying now.
One solution to this problem may involve not pain management but the management of expectations of pain relief. That is, learning to manage pain with fewer or no highly addictive opioids. The reasoning is that the opioid epidemic is driven in part by people who have never taken opioids before (the “opioid-naïve”) taking opioids after surgery and becoming addicted.
Researchers at the University of Michigan found that this was possible, at least for the six mainly laparoscopic surgical procedures in their pilot study.
According to the article in the Journal of the American College of Surgeons, 190 patients were included in the study. Before surgery, they were counseled to expect pain and on how to control it without opioids. They were given alternate medications: prescription strength acetaminophen (650 mg) and ibuprofen (600 mg).
They also were given a small number of opioids for “breakthrough pain” that didn’t respond to the other methods or medications. At the end of the study, more than half the patients had used no opioids, and they reported an average lower pain score than the ones who did.
Although the study is small, it’s encouraging.
- Water therapy
- Hot and cold therapy
- Cognitive-behavioral therapy
- Transcutaneous electrical nerve stimulation (TENS) Treatment
No one method works for everyone. For some people, even some chronic pain patients, prescription opioids are the best treatment option. For others, holistic therapies. But if you or your doctor thinks a drug-free alternative might give you better results, keep an open mind. We already have too many people with opioid use disorder as is.
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