Pain, The Opioid Epidemic and How Health Care Has to Improve

Pain, The Opioid Epidemic and How Health Care Has to Improve

Opioid addiction is a national epidemic—and so is chronic pain. Could there be a relationship?

1.  In 2015, 2 million Americans had a substance use disorder involving prescription pain relievers. By the end of the year more than 33,000 people had died from opioid overdoses involving prescription painkillers, heroin, fentanyl or combos.

2. A study in the Journal of Pain stated: 126.1 million adults reported experiencing pain in the previous three months, with 25.3 million adults suffering daily pain and 23.4 million reporting a lot of pain.

It’s estimated that the economic cost of pain in the US (in 2012) amounted to as much as $365 billion annually! But some major healthcare plans won’t pay for physical therapy (a proven pain remedy for soft tissue and joint pain) unless you’ve had an operation! And they won’t pay for you to learn stress management techniques—a recognized way to manage all types of pain. In many situations, physical therapy (and physical activity) and/or stress management can make an operation unnecessary.

3. Sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014, . In 2015 and there were 249 million prescriptions written for oxycodone and hydrocodone in 2015, but there has not been an overall change in the amount of pain Americans report.

Seems to indicate the go-to treatment for pain in the U.S. is prescription opioids! At the same time, the CDC estimates opioid overdoses kill more than 90 people a day!  

4. Some states have particularly entrenched problems: In six years, opioid wholesalers shipped 780 million oxycodone and hydrocodone pills into West Virginia—that’s 433 pills for each person in the state.

Clearly, a lot of docs aren’t interested in or don’t have the resources to find alternative ways to manage patients’ pain.

5. Conversely, there are communities that report pain is undertreated! For example, African Americans with sickle cell anemia say they often have trouble getting pain relief medications. 

Racially and socio-economically-based healthcare biases may fuel illicit use of pain meds. And un-prescribed use means there’s NO CHANCE for the user to access a pain management specialist.

How do you stop the opioid epidemic? Stop the pain first! Here’s our six-step plan to help relieve your pain.

What YOU Can Do
1. See a doctor/specialist for an accurate diagnosis of the cause of your pain—millions of you try to manage it by yourselves, using drugs or alcohol to cope.  

2. See a physical therapist if appropriate and stick with the prescribed routines. Work with your doc to devise a routine if you’re not covered.

3. Adopt stress reduction practices (stress amplifies pain; pain amplifies stress). We advocate deep breathing, mindful meditation, acupuncture, cognitive behavioral therapy, yoga, and loving intimacy!

4. Use ice and heat—with your doc’s guidance. In general 15 minutes of heat, followed by 15 minutes of ice, and another 15 of heat can ease inflammatory pain.  

5. Try over-the-counter NASIDs (ibuprofen, naproxen sodium, etc.) or prescription NSAIDs (cox-2 or -3 inhibitors).  

6. Under supervision of a pain management specialist (that’s of PRIME importance), don’t be afraid to use opioid pain relievers as directed. A Cochrane review of opioid prescribing for chronic pain found that less than one percent of folks (weeding out those who already had drug problems) developed new addictions during pain care; a more recent study estimated it was 8 to 12 percent.  

What Needs to Be Done
You can do a lot to ease your pain and protect yourself from dependence on pain meds, but the healthcare system needs to change to stop the opioid epidemic. We need truly comprehensive health insurance that provides supervised pain management for everyone, so no one has to go looking for relief in all the wrong places!

Various pain management therapies including stress management, physical therapy and chiropractic, need to be covered by farther-reaching insurance plans. That solution is cheaper than medical procedures, would save big bucks…and countless lives. 

Medically reviewed in December 2018.

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