While the experts here at Holistic Pain want to promote alternatives to opioid medications to treat pain, we do understand that there may be some instances when it is the best solution. We believe that a conservative approach to this type of medication is always the best course of action, however.
Let’s take a look at some of the reasons when considering opioid treatment may be the most advantageous option.
Opioid medications for short-term relief
Due to the potential of developing an opioid addiction when using the medication for an extended period of time, one of the better uses is for short-term pain relief only. Opioid medications can be effective if they are prescribed for individuals who are undergoing surgery or are experiencing isolated pain due to an injury. As soon as the medication begins to be ineffective, however, there is greater risk for the patient. They run the risk of taking more medication for the same effects which can lead to continued use even after the initial pain has subsided.
The best use of this medication for acute pain is to utilize it only during a very short period of time immediately following the illness or injury. Often it is prescribed to be used “as needed” and, if relief is present using other types of pain relievers, the use of the opioid can be avoided altogether.
Of course, for some patients other therapies, treatments, or medications may not have an effect. If this is the case, it is appropriate to talk to your doctor about alternatives such as opioid painkillers. This kind of treatment should be closely monitored by your doctor to prevent overuse, dependence, and addiction and only used with their express approval.
Use of opioid medications for terminal cancers
Painkiller medications may be used effectively for individuals dealing with the effects of a terminal disease, such as cancer, who are in hospice or receiving palliative care. The use of these medications can help with the reduction of pain caused by the disease and its treatments. In spite of science’s best advancements in the treatment of cancer, some forms remain terminal and untreatable. In the instance that a patient is facing a terminal diagnosis, the use of these pain management drugs can be helpful, but they should also be monitored closely.
Not a good choice for chronic pain
However, most importantly, opioid medications remain a poor choice for individuals suffering from the effects of chronic pain. There is some recent research to back up the argument that patients with chronic pain should avoid prolonged opioid use.
In November of 2014, a report published by the medical journal PAIN demonstrated the correlation between prescribed painkillers and mortality rates among chronic pain patients. Researchers made associations between opioid-related overdoses and the increase of prescriptions for these types of medications to chronic pain patients not diagnosed with cancer. The higher risk of mortality was found among patients prescribed opioids for long-term use as opposed to individuals who used them on a short-term basis.
There were a number of factors in these deaths, including a higher risk of poisoning. In fact, long-term opioid users had a four times higher risk of poisoning than individuals without a chronic pain diagnosis.
From Drs. Harald Breivik and Audun Stubhaug from the Department of Pain Management and Research at the University of Oslo:
“Safe and effective treatment of opioid-sensitive pain is possible but continues to be a double-edged sword that is difficult to handle. It requires deep pharmacological knowledge, experience, resources, considerable patience, and mental energy from a group of helpers who are able to take care of the whole bio-psycho-social conundrum of the chronic pain patient.”
The Cleveland Clinic backs up this research with an informative blog post from October of last year. For too long doctors were prescribing opioids to patients without considering the long-term effects in their effort to stem chronic pain. The years since that trend became popular demonstrated that this approach was not only ineffective but also dangerous. Dependence on these painkillers develops very quickly and, without the right support, patients are at a high risk of addiction and death. In fact, between 15,000-18,000 deaths are reported each year related to the overdose of prescription medications. A phenomenon known as “pill mills” became prevalent which helped individuals get access to these drugs even without the care of a physician. Luckily, most states are implementing programs to crack down on these for-profit drug centers.
In truth, opioid medications do not provide adequate pain relief when used long-term due to the body’s ability to process these chemicals and develop a tolerance. Patients using the drugs over long periods of time typically need to increase their dose to get the same relief they felt at the beginning of treatment. They also carry with them a whole host of side effects including addiction.
Opioids should only be an option for acute pain, terminal conditions, or when other therapies simply do not work.
If your use of opioid medications has been approved by your physician, you should develop a plan that can help you safely and effectively use these drugs in order to avoid long term dependence issues. Our partners at PainDoctor offer this 12-step checklist for patients and their care providers to use to help manage their treatment.
Have you used opioid medications to treat short- or long-term pain? What was your experience?
Image by Nadia Hatoum via Flickr