5 Ways To Reduce Your Risk With Opioids

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5 Ways To Reduce Your Risk With Opioids

There is often a lot of talk about the dangers of opioids, but for many people the use of these painkillers is all that is standing between them and debilitating pain. Opioids work by reducing the pain signals that are sent through the nervous system to the brain which causes the body not to experience the intensity of the pain. The controversies over opioids result from the highly addictive nature of the substance. Because the medication changes signals to the brain, it can be habit forming and become easily abused.

Recent studies on risk and opioid medications

Just a few weeks ago, the American Academy of Orthopaedic Surgeons reported on the impact of the use of opioids on orthopedic care in the United States. While the U.S. makes up only a small percentage of the global population it consumes almost 80% of the global opioid supply, according to the study. It accounts for 99% of the consumption of hydrocodone, which is the most commonly prescribed opioid medication in the world. These numbers are astounding and obviously a cause for concern. This may come down to the trust factor between patients and their physicians.

In April the Journal of the International Association for the Study of Pain included a report regarding the percentage of medications that are prescribed and misused. By their calculations between 20-30% of the opioid drugs prescribed as pain therapy are used inappropriately by patients and 10% of these prescriptions lead to addiction. They also believe that these rates of misuse are unique to the United States, which seems to support the findings of the American Academy of Orthopaedic Surgeons. They also question whether or not benefits of opioid prescriptions outweigh the risks.

Unfortunately, far too much of the research into opioids are due to the negative impact of their misuse. This study into the use of opioid medications among young people was published in March by the American Marketing Association. The authors of the article point out that the Centers for Disease Control have labeled the misused of prescription opioids as an epidemic in this county and some of the most vulnerable victims are teenagers. In the study, the teenagers surveyed were asked not only about their use of drugs and alcohol but also about their anxiety levels, their desire to fit in, and other psychological issues most commonly experienced by people their age. The results showed that the use of prescription drugs increased in proportion to the anxiety levels these teenagers were feeling in their lives.

Back in January the University of Connecticut released a study showing there is a concerning lack of data regarding opioids and chronic pain. The report was based on a white paper published by the National Institutes of Health that indicated that the findings typically cited to justify the use opioid medications for chronic pain patients have very little backing evidence to support them. While there is very little evidence to demonstrate that opioid drugs have very little long-term efficacy for chronic pain, the rates of prescriptions are continuing to increase. Where the results of this study get confusing is that there are pain conditions that are responsive to opioids but others that do not respond to them at all. Doctors, however, often prescribe these medications across the board.

How to reduce your risk

If you have found success with opioid medications, it is extremely important that you have access to the tools that can mitigate your risk of developing a dependence or addiction. Here are some ways for you to keep in mind.

  1. Work with your doctor: Far too many people misuse opioid medications. The body is able to build a tolerance to these drugs so some people will try to take more to compensate for the lack of pain relief. Instead, it is extremely important to talk to your doctor about the changes in your symptoms and how the drug is working.
  2. Recognize signs of overdose: Immediate medical attention is important if you’ve taken too much of these medications. Let your friend and family know some of the signs that they should look for and be able to contact medical help immediately. Here is a comprehensive view on opioid overdoses to keep on file.
  3. Use apps to help you monitor your use: What’s the point of living in the 21st century if you can’t make use of today’s technology? There are multiple apps available for all smart phone platforms that can help you monitor your use of medications and give you reminders of when to take them and how much.
  4. Combine your treatment with alternatives: Some patients have a lot of success reducing the levels of their chronic pain by combining medical treatments with lifestyle changes. Mindful meditation, herbal supplements, exercise, and diet alterations can all have a positive effect on your overall health which then can reduce your dependence on these medications.
  5. Monitor who has access to your medicine cabinet: Sometimes the bigger concern than your own dependence on opioids is the risk of unintentionally providing access to others in your household. If you have teenagers who might be struggling with anxiety make sure you keep your medications in a secure place and talk to your kids about their experiences. Find them the appropriate treatment.

While there are plenty of concerns with opioid medications, there are right and wrong ways to utilize the drug for your treatment program. Work with your doctor, form a plan, and monitor your use and you may be able to successfully use opioids to reduce your chronic pain while avoiding risks of their use.

How can you reduce your risk with opioid medications?

Image by frankieleon via Flickr

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About the Author:

At Holistic Pain, we have a passion for helping you and those who around you who suffer from pain find relief. Part of that passion extends to education and transparency. In our Holistic Pain blog, we focus on new research studies, along with our own tips, for maintaining and improving your quality of life, even with pain.

2 Comments

  1. Bob Schubring June 6, 2015 at 4:29 pm - Reply

    The most common explanation for a pain suddenly becoming worse, is that the disease process that causes the pain, has itself gotten worse.

    Opioids affect two parts of the brain. The periaquenductal grey matter, or Pain Center, is the target of these drugs. But the nucleus accumbens, or Pleasure Center, also responds to them. Normally, the Pleasure Center gets over it’s surprise at the presence of opioids after a few days. This is why, if your doctor has you on long-term opioid therapy, you can walk without staggering and aren’t sleepy from your medicine now, even though it had that effect when you first began taking it.

    The Pain Center, meanwhile, uses the opioid molecules as we might use a volume control on a TV set. If the pain alarm is sounding repeatedly, about an old injury that’s annoying, opioids tell the Pain Center to turn down the noise and allow you to go on about your business normally. In fact, opioids are based on a substance in the poppy plant, that is structurally similar to Endorphin, a hormone we produce when we exercise. This hormone does exactly the same thing after a workout. It tells your pain center that your tired muscles ache a little but this is nothing dangerous.

    Endorphin and the opioids are unique at modulating the pain response.

    All the other powerful drugs, that are used to sedate people during surgery, simply shut down huge portions of the brain. We don’t feel the surgeon digging out a kidney stone, because we’re completely unconscious. The opioids (and endorphin) enable us to control pain, while fully conscious.

    So what is actually meant by “tolerance”?

    The pleasure center learns to tolerate the presence of whatever amount of endorphin or opioids, sets the pain alarm’s volume to the right level. Meaning one feels some heightened sense of pleasure when first taking one’s medicine, but the pleasure fades back to normal soon. That is normal.

    What’s dangerous, is when your pleasure center is unable to feel pleasure at all, unless you take opioids.

    If this happens, it may be a sign of a serious illness, called Anhedonic Depression. Anhedonic Depression is not fully understood. It may result from trauma to the brain. Excessive stress and fatigue can cause it. It sometimes results from post-traumatic stress disorder. It can also result from childbirth. Some cutting-edge research suggests that an infection in the brain may be a major cause.

    There is no preventive treatment yet, for anhedonic depression. However, many of the symptoms can be controlled with medications that adjust the neurotransmitter molecules in the brain. These include serotonin reuptake inhibitors and monoamine oxidase inhibitors. If you suffer anhedonic depression and your doctor puts you on one or the other of this class of drugs, they will make you less exhausted and better able to sleep restfully.

    It is important to be specific in discussing your illness with your doctor. If you feel sad or hopeless for no apparent reason, and the sadness went away when you began taking opioids and now it’s back, you should ask your doctor if you may be depressed.

    Suffering any chronic illness…especially one that hurts, is going to disrupt your life, and that’s stressful. Learning new ways to enjoy life, can be hard. Learning anything, is harder under stress. Many people have gotten depressed, and the trigger may have been less stressful than the illness you are experiencing. Don’t blame yourself for feeling depressed. Tell your doctor and get help for it.

    And, obviously, don’t tell your doctor that your pain hurts worse, unless iit actually DOES hurt worse.

    A sudden increase in pain, may mean that you need an operation to fix something that’s gotten worse. Most doctors will try to diagnose what’s causing the pain.

    A profound feeling of sadness, hopelessness, or despair, combined with an inability to fall asleep at bedtime, nightmares that are frightening and keep one awake, etc., can be signs of depression, for which you need a different medicine, than the one your doctor gave you to control pain.

    Tell your doctor which problem you have.

    If you try to oversimplify it for the doctor, your doctor may think you aren’t being honest, and this will cause problems, because your doctor is trained to learn about your condition, in part, from what you feel. The patient who doesn’t cooperate in describing their illness, is making an enemy of their doctor, who should be their ally.

    And of course, a sudden increase in pain, that your medication cannot control, may indicate a new illness or injury, or a worsening of an existing illness. Do not take more pain medicine than your doctor directs. DO seek treatment for whatever is making you worse.

  2. Robin in Minneapolis June 7, 2015 at 10:05 am - Reply

    I am a patient at a pain clinc. I also am prescribed a variety of narcs, but in their prescribing of said narcs, their ultimate goal is to get mostly all of their patients on nerve stims or implantable pain pumps. They obviously get generous funding from Medtronic, which is also based in our home state. Upon my refusal to have either a pump or a stim implanted, they told me that I would no longer be accepted as a patient.
    I thought this was the craziest thing ever. I have had 13 spinal surgeries, am still quite functional and on very small doses one narcs.
    I am now seeking holistic therapies to rid myself of the numbers game that ‘us’ as patients have turned in to.

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