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Managing Your Pain to Protect From Opioid Addiction

Managing Your Pain to Protect From Opioid Addiction

Headlines declaring life expectancy in the U.S. have declined for the first time since 1993 because of deaths from opioids is a major red-flag warning that, as a nation and individually, we need to change our approach to managing pain, taking opioids and addressing illicit drug use.

The CDC reports that, between 2015 and 2016, there was a 28 percent increase in fatal opioid overdoses! In 2016, more than 63,000 Americans died of drug overdose—and 42,249 of those deaths involved opioids.

To focus the country’s healthcare providers on the problem, the FDA asked the National Academies of Sciences, Engineering and Medicine to develop a plan to curb the epidemic. Their report, “Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use,” is out, as are additional publications, Congressional testimonies and journal editorials based on the findings.

What you need to know about opioid use
If you or a loved one is dealing with acute, chronic or surgery-related pain, it’s important to understand the risks and benefits of using opioids and to learn about the full range of pain-management alternatives that are available. A study shows that 60 percent of opioid overdose deaths involve people who suffer from chronic pain.

The benefits of opioid use: Severe pain interferes with healing, quality of life and overall health and wellbeing. Opioids can eliminate severe pain and allow you to heal or participate in activities (such as physical therapy) that will help you to alleviate pain.

The risks of opioid use: Unless pain medications are administered within a pain management plan that targets tapering off the drugs as you heal and feel better, it is possible to become addicted even at low doses. (Management of chronic pain associated with end of life is another matter; hospice targets comfort for whatever time remains.)

Steps to take to effectively manage your pain:

  1. If opioids are the right medication for your pain control, ask your physician to refer you to a pain-management specialist who will guide you through your medication regimen and protect you from addiction.
  2. Be conscientious about physical therapy, changing your diet to decrease pain/inflammation, adding stress management and other at-home activities when prescribed. It may seem counter-intuitive that the strain (and sometimes pain) of physical therapy, along with diet and meditation, can ease chronic pain, but it can!
  3. Ask your doctor about taking non-opioid analgesics, including ibuprofen and prescription NSAIDs like celecoxib (Celebrex) and indomethacin (Indocin). A study in JAMA found that for “patients presenting to the ED [emergency department] with acute extremity pain, there were no statistically significant or clinically important differences in pain reduction at two hours among single-dose treatment with ibuprofen and acetaminophen or with three different opioid and acetaminophen combination analgesics.” Why does this matter? It has been reported that nearly 19 percent of people leave EDs with an opioid prescription—and even short-term use can trigger dependence. We suggest that, even for persistent pain, some NSAIDs are more or less equivalent in effectiveness to low-dose opioids.
  4. Explore medical massage to ease distress. Consider trying acupuncture, pain management group therapy, gentle stretching, water therapy or exercises such as tai chi or yoga (if the doc says they’re okay).

What the government needs to do

  1. Make sure pain management therapies that do NOT rely on drugs are covered by insurance. Insurance companies are more likely to cover an oxycodone prescription than acupuncture treatments.
  2. Adopt a wide-ranging public health perspective that targets both prescription pain medication abuse and heroin/fentanyl abuse. And institute evidence-based guidelines for allowing opioid prescriptions. One study found that, post-surgery, 43 percent of opioid prescriptions were not necessary for patients’ wellbeing.
  3. Make sure that an overdose medication such as naloxone is widely available to EMTs, healthcare facilities, etc.

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