In recent years, I have had to deal with chronic pain, more specifically nerve pain. My ortho doc and physical therapist determined the pain is coming from compression on nerves in my back and pelvic floor, which radiates down both my legs.
My general practitioner, along with my pain management team, prescribed Gabapentin in lieu of opioids to manage the pain. Gabapentin is generally utilized alongside other drugs to prevent and manage seizures. For me, it is being used to alleviate neuralgia or nerve pain. Gabapentin is categorized as an antiepileptic or anticonvulsant medication and can be utilized to treat other nerve pain disorders, such as diabetic neuropathy, peripheral neuropathy, and trigeminal neuralgia.
According to the Centers for Disease Control and Prevention (CDC), “ Nearly 108,000 people died from drug overdose in 2022 and approximately 82,000 of those deaths involved opioids (about 76%).
The number of people who died from an opioid overdose in 2022 was 10 times the number in 1999; however, opioid overdose death rates were relatively stable from 2021 to 2022,”.
The opioid family of drugs includes natural, synthetic, and semi-synthetic opioids. Opiates, such as morphine and codeine, are natural opioids found in the opium poppy. Synthetic opioids, such as methadone, are chemically made. Heroin is a semi-synthetic opioid and is made from morphine that’s been chemically processed. It enters the brain quickly and produces a more immediate effect.
Regardless of how it is used, the effects of heroin generally last for three to five hours, depending on the dose. What startled me was that people who use heroin on a daily basis must use every six to twelve hours to avoid getting sick with withdrawal symptoms. Wow, talk about exhausting!
Since opiates produce high levels of positive reinforcement, of course it increases the odds of developing an addiction despite the negative consequences. Unfortunately, in the U.S. opiate addiction is a chronic lifelong disease and without complete recovery, consequences like disability, relapses, and death are inevitable. Addicts have limited options – they either get locked up, covered up or sobered up.
*Note: All content within this article is meant for informational purposes only and is in no way a replacement for professional medical or psychological advice or support. Seek immediate and appropriate care from a healthcare professional should you or a trusted loved one deem it necessary.
What are safer alternatives to opioids?
Non-Opioid Pain Management
- Therapies
- Massage
- Acupuncture
- Cold and heat therapy
- Occupational Therapy
- Physical Therapy
- Chiropractic Therapy
- Yoga and regular stretching
- Relaxation training
- Topical remedies like creams and ointments
- Exercise and movement
- Medications
- Acetaminophen (e.g., Tylenol)
- Anesthetics.
- Non-steroidal Anti-inflammatory Drugs (e.g., Aspirin, Ibuprofen)
- High-tech treatments using radio waves and electrical signals
Recently published guidelines note that massage therapy is an effective way to treat chronic pain, with studies also showing benefits for treating migraines and arthritis. While most people typically think only of a massage when they hear the words “massage therapy,” there are also non-touch forms, such as acupuncture and cupping.
One of the most common massaging tools is a simple ball that can be used to apply pressure to muscles, typically by rolling it along the muscle or holding it in place while applying gentle pressure. You also can massage your own muscles by squeezing the ball between your hands or trying other gentle movements. Using a hard tool, such as a ball, might save you from overworking sensitive tissues.
How do you deal with pain without opioids?
Here are some things to consider when making a pain management plan:
- Be open to managing pain without opioids
- Be informed and know your options
- Talk to your doctor about which options may work for you; work with a specialist if needed
- Follow up regularly with your doctor about your pain and whether your plan is working or not
- Understand that it can take time to reduce your pain
Are opioids really effective for acute pain? Why are they used so much in treating pain?
Opioids for acute pain is a complex Issue. While opioids can be effective for managing severe acute pain, such as that experienced after surgery, their long-term use and potential for addiction have led to significant concerns. The CDC guidelines emphasize that opioids should be prescribed for the shortest duration necessary, and at the lowest effective dose.
There are several factors that contribute to the widespread use of opioids, such as:
Misconceptions about addiction: Many people believe that opioids are not addictive when used as prescribed, but this is a common misconception. Even short-term use can lead to dependence and addiction.
Inadequate pain management education: Healthcare providers may not receive sufficient training on non-opioid pain management strategies, leading to over-reliance on opioids.
Pharmaceutical industry influence: Aggressive marketing campaigns by pharmaceutical companies have promoted the use of opioids for a wide range of conditions, including chronic pain.
Patient expectations: Patients may expect opioid prescriptions for pain relief, and healthcare providers may feel pressured to meet these expectations.
What are the long-term effects of taking pain medicine?
Long-term painkiller abuse can lead to serious cardiovascular issues, heart attacks and heart disease. Stomach and intestinal issues can arise even after a day or two of taking painkillers. Up to 80% of patients taking opioids experience at least one side effect such as constipation, bloating, vomiting, abdominal distention, bowel obstructions and hemorrhoids, dry mouth, excessive sweating, and weight gain, loss of appetite, sexual dysfunction, and dry skin.
Central nervous system side effects are also common, like impaired concentration, confusion, sleep and memory problems. With ongoing usage, a tolerance can develop to some of the side effects, but constipation does not subside and typically has to be treated.
Ironically, over time, opiates increase pain – a phenomenon that is not well understood, but for some patients, they quickly experience more pain than before they took the medication. When patients have this side effect, they typically must explore other pain management options, as opioids will not be effective in their case.
Non-opioid treatment for chronic pain
In conclusion, it is always vital to have an honest conversation with a healthcare provider about the risks and benefits of opioid use, and most importantly, explore non-opioid alternatives whenever possible.