Chronic Non-Malignant Pain Opiate Options

You got pain?  Take a pill to ease the strain.  Chronic nonmalignant pain affects everyone.  It can be a major cause of personal and family distress.  In addition to the pain of pain many live with secondary effects such as depression which leads to family chaos, work absenteeism, and decrease in activities of daily living to the point of depression.  Prescription medication like nonsteroidal anti-inflammatory drugs (NSAIDs include ibuprofen, naproxen, celebrex and more) and opiates (oxycodone, hydrocodone, codeine, morphine and more) are the gold standard for acute and chronic pain management.  Once you have seen the doctor you are most likely to get one or both of these depending on the etiology of the pain.  Once the cause of the pain is found and treated the need for pain medication may cease.  If this fails to work, the pain meds continue.  This can be a hazard to your health.

In 2012 there were about 183,000 deaths worldwide.  In 2014 there were over 47,000 lethal drug overdoses making it the leading cause of accidental death in the United States (2012 statistics: United Kingdom: 3,200, South America/Latin America/ Caribbean: 7300, European Union: 6100, Oceania: 1900).   This exceeds the number of deaths in road accidents in most countries. Research from studies done in 2013 revealed that opioid analgesics were the primary cause of most drug overdoses in the United States.  Over three-quarters of these deaths were accidental or unintentional.  Opioids (75%) were the most common drug followed by benzodiazepines, antidepressants, and antipsychotics.  Prescription pain relievers accounted for over 18,000 overdose deaths.  Misuse of these medications often leads to illicit heroin use.  Why?  It is easier to get and less expensive than prescription opioids even though the rate of prescribing opioids has almost tripled since 1994.  This has increased the mortality rate from overdosing over 400% in women and over 200% in men from 1999 to 2010.

Pain can be managed in ways that use less prescription pain medicine.  The pill may be the easiest way and is usually the first thing a patient is offered.  There are many options to finding relief while decreasing your risk of opiate dependence or overdose. Your doctor can do the following:

• advise on other treatments and refer to appropriate specialists
• discuss risks, side effects, etc of prescription pain drugs
• educate, provide resources for education on the diseases, pain management (articles, books, videos, agencies like Partnership for Drug Free America)
• prescription drug monitoring (doctor-patient contract, drug tests)
• use of non medicinal treatment
• identify risky drug use patterns
• require visits for refills
• referral to pain management specialist
• behavioral therapy consult

Opioid dependence and overdose can be prevented.  Using opioids responsibly is the patient’s responsibility.  It is up to you to recognize what these types of drugs can do to you.  Relief of pain is the objective; however, the addictive potential must be taken into consideration.  It is important to get a correct diagnosis of the pain as there is probably non opiate treatment that can make it tolerable or resolve it totally.  Make opiates the option instead of the treatment of choice.  Best health!