Everyday in the United States, 41 people lose their lives due to opioid prescription overdose.1 National Pain Awareness Month is not only a time to bring awareness that chronic pain is real and that it can affect you emotionally, physically, and mentally, but that opioid abuse and misuse exists. Opioids are often prescribed after surgeries and trauma events like car accidents and to treat chronic pain, but they can have dangerous side effects. How can this be prevented? These effects can be avoided by using innovative, non-drug treatments that are safer!
What are opioids?2
Opioids are related to the opium poppy that comes from the opium plant that has pain relieving effects. Opioids act centrally at opioid receptors to affect your brain and spinal nerves by blocking pain signals from reaching your brain. They reduce the release of painful chemical signals, so pain is not felt. However, they come with risks of abuse, dependence, addiction, respiratory depression, confusion, restlessness, and euphoria or extreme pleasure. Opioids change how your brain functions, so they can lead to tolerance where you will need more of the drug to reach the same level of effect or dependence which is when you start to feel sick if you do not take them regularly. You do not know how opioids will affect your brain before you take them and not everyone on them becomes addicted. Addiction can even result from taking them as prescribed.
Addiction or Opioid Use Disorder is associated with compulsive behaviors to continue getting and taking opioids. You continue to take them even when you know they hurt your relationships and damage your ability to perform your work, school, and home tasks. It is treatable through the use of recovery programs and medication-assisted treatments to reduce your cravings and withdrawal effects. Since opioids affect the part of the brain that is responsible for controlling your respirations, they can slow your breathing or cause death if a dose is too high. Since they can make you sleepy or sedated, they should not be combined with alcohol and other sedating medications like sleeping medications. Another limiting side effect of opioids is constipation, so if they are prescribed long-term, they are often taken with medications to stimulate your bowel movements.
What is the opioid epidemic?1-3
The opioid epidemic is a result of the increased opioid prescriptions that occurred during the 1990s when pharmaceutical companies reassured providers that they were not addictive. As they began to be misused, both prescription and non-prescription opioids, it was clear these drugs had dangerous effects like leading to addiction. Opioids are effective for treating pain, but they can result in misuse, overdose, and addiction if used for long periods of time or at high doses.
According to the Centers for Disease Control and Prevention, about $78.5 billion is the “economic burden” of opioid misuse in the United States. The economic effects of opioid misuse include healthcare costs, loss of productivity, addiction treatment, and criminal justice involvement. It is estimated that over 650,000 opioid prescriptions are filled, but are not being used for medical purposes like moderate to severe pain relief. For people that are using opioids for long-term pain relief, about 1 out of 4 struggle with opioid addiction. Even during the COVID-19 pandemic, opioid-related overdoses and deaths continue to increase which could be related to mental health and financial issues. This really shows how big of a harmful impact opioids have!
How big of an issue is pain?1-5
Over 30% of Americans live with chronic pain and it is the most common disability that affects daily activities and relationships in the United States. A 17-year study found that the prevalence of pain in adults of all ages is increasing in the United States. Joint pain cases have increased by 21%, neck pain cases have increased by 16%, and low back pain cases have increased by 15%. As pain continues to be an issue and opioid-related overdoses and addiction across the United States continue to rise, it is important that alternative and safe pain treatments are considered.
What are other non-drug treatment options?1,6
Continuous peripheral nerve block (cPNB) – cPNB utilizes a catheter to place at the target nerve that is causing pain, so it reduces the pain impulses that go to your brain for you to feel pain. It works by providing pain relief locally to the area by using non-opioid drugs that decrease the pain at that area. This treatment can be used during and after surgery to reduce the severity of post-surgical pain and the need for opioids. By reducing the need for opioids, this protects you from their addicting, dangerous, and unwanted side effects.
Peripheral Nerve Stimulation (PNS) – PNS is a unique way to provide pain relief because it occurs by using an electrical device. The small device is a wire that is implanted next to a peripheral nerve or a nerve that reaches beyond your brain and spinal cord. The device sends quick electrical pulses to your nerves to block pain signaling from reaching your brain. It is a quick and simple procedure that is likely painless due to the small size of the device. PNS is commonly used for diabetic peripheral neuropathy, and pain in the neck, back, and face.
Deep Transcranial Magnetic Stimulation (TMS) – Deep TMS is a non-invasive procedure that involves using magnetic technology. Magnetic fields are created by a coil that is placed on your head to stimulate your brain to block pain signals from reaching your brain. As a result, your brain will not begin the process for you to feel the pain you are having. It only requires a few 20 minute sessions each week over six weeks to reach its full effects. Deep TMS has also been used for treating depression and obsessive compulsive disorder.
Pulsed Electromagnetic Field (PEMF) Therapy – PEMF therapy works by using electric and magnetic energy to stimulate your body to increase its pain relief mechanisms while decreasing the pain and swelling mechanisms. It flushes out toxic cells that cause inflammation while increasing the delivery of nutrients to your tissues. It is commonly used for neuropathic pain that is created within nerves, not from an injury like stomping your toe. This therapy is also non-invasive and can even be used at home.
Cryotherapy – Cryotherapy or cold therapy is typically used for treating warts and some cancers, but it has been shown to reduce pain for osteoarthritis and rheumatoid arthritis. Cryotherapy stimulates your body’s response to extremely cold temperatures which increases cell survival and strengthens your immune system. This results in decreased inflammation and swelling that can cause pain. The cold therapy is delivered to your peripheral nerves through a small, handheld device which reduces nerve activity of transmitting painful signals. It also reduces the use of opioids after surgery while increasing your body’s ability to reduce inflammation and promote healing.
Botox – You may think of this as only for a cosmetic procedure or for treating migraines, but it can be used for pain too. Botox is a weak form of botulinum toxin type A that is produced from bacteria to block muscle contraction. For pain, it blocks the release of chemical signals and messengers that stimulate your brain to respond to pain. Research is still on-going with this therapy, but it has been shown to be useful in providing temporary pain relief for nerve and back pain.
If you currently take opioids, talk with your provider or pharmacist if you have questions or concerns about their effects. If you or someone close to you needs help for a substance use disorder, talk to your doctor or call the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline at 1-800-662-HELP or go to SAMHSA’s Behavioral Health Treatment Services Locator.
References:
- Pain awareness month: Innovations in Pain. A4M blog website. https://blog.a4m.com/pain-awareness-month-innovations-in-pain-management-and-care/. Accessed September 27, 2021.
- Opioids. Centers for Disease Control and Prevention website. https://www.cdc.gov/opioids/patients/materials.html. Accessed September 27, 2021.
- Opioid overdose crisis. NIH website. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis. Accessed September 27, 2021.
- 10 facts about pain – National pain awareness month. Reinhardt chiropractic website. https://www.reinhardtchiropractic.com/blog/10-facts-about-pain/. Accessed September 19, 2021.
- Americans in pain. McShane Welding website. https://www.mcshanemetalproducts.com/blog/americans-in-pain. Accessed September 27, 2021.
- Botox for pain relief. Regional Neurological website. https://www.regionalneurological.com/botox-for-pain-relief-how-it-works/. Accessed September 27, 2021.
