In recent years there has been amplified attention on opioids and their role in pain management. Opioids are a class of drugs that includes illicit drugs like heroin and prescription medications like oxycodone. Some opioids are prescribed as pain medications while others have no medical use and are illegal in America. Opioids bind to specific receptors in the central nervous system. In doing so, they change how the body senses pain. Unfortunately, along with being powerful, effective pain relievers, opioids have serious side effects. Opioid pain medications can be incredibly difficult to stop misusing. Even when used as prescribed, people can and do become obsessed with misuse. Opioids also depress breathing, which can cause a fatal overdose. Prescription opioid overdoses are often accidental.
Due in large part to high prescription rates, the U.S. is grappling with a devastating opioid epidemic. Since 2000, half a million people have died from opioid overdoses, and despite the push to change the trends, opioid pain relievers do remain the first-line choice for moderate to severe acute pain, especially in emergency rooms. There are tens of thousands of overdose deaths each year, and millions struggle with opioid addiction. Now there is starting to be increased scrutiny on the prescribing of these drugs. There is also an effort to find alternatives in the form of effective non-opiate painkillers.
Doctors and hospitals are advised against using opiates as first-line pain management. dependence are all common side effects of opiate painkillers. Alternatively, the benefits of non-opiate painkillers include a lower risk profile, and in some cases, pain control can be improved as well.
A recent study released in 2017 showed no significant difference in the pain relief offered by opioids and non-opiate painkillers. The study looked at adults visiting emergency departments for arm and leg pain related to injuries including sprain and fracture. After two hours, there was no major difference in pain reduction when patients were given ibuprofen-acetaminophen versus comparison opioid combination drugs. This research strongly supports the idea that opiate painkillers are not the best way to treat pain.
Doctors who work in emergency departments say they are working to change how opiate painkillers are prescribed. Many physicians report having open discussions with their patients about the risks of opiates including uncontrolled, compulsive use. The overall objective is to bring down the number of people exposed to prescription opioid pain relievers. Along with the risks of continual and uncontrolled obsession with the drug, there are other negative side effects as well. Nausea, vomiting, constipation, and physical
Several types of drugs may be effective as non-opiate painkillers. One example is non-steroidal anti-inflammatory drugs or NSAIDs. These include ibuprofen, aspirin, and naproxen. For acute pain, they work well as a first-line treatment, and they’re available in over-the-counter and prescription formulations. Acetaminophen is another painkiller available in over-the-counter brand names like Tylenol as well as an unbranded, generic medication. Acetaminophen has been shown helpful for cancer pain, arthritis, and headaches.
Tricyclic antidepressants are being looked at as an effective pain reliever, especially for nerve pain. Other categories of antidepressants including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are being researched for their use with chronic pain. Anti-epileptic medications can help with nerve and chronic pain from conditions like shingles and fibromyalgia. Corticosteroids, often just called steroids, can help with pain related to an overactive immune system and inflammation. This type of drug may help with pain stemming from conditions including back injuries, joint pain, nerve pain, and cancer.
Outside of drugs, there are also alternative pain management treatments being explored in a mainstream way. For example, more physicians are encouraging options like acupuncture, cognitive behavioral therapy, biofeedback, and relaxation training to help with chronic pain in particular. The Centers for Disease Control, the American College of Physicians and The U.S. Department of Veterans Affairs all advise non-medication treatments as the first-line option for chronic pain relief.
Non-opiate pain relievers, including both medications and alternative treatments, can be effective. Exploring more non-opiate pain relievers may help curb some of the opioid uncontrolled obsession cases and overdose deaths in the U.S., particularly as both patients and doctors learn more about these options. This doesn’t mean non-opiate painkillers don’t have side effects, but they tend to be more limited, and none of the above non-opiate pain relievers are considered to cause compulsive use.
If you or a loved one struggles with prescription opiate pain relievers or other drugs, please contact The Recovery Village. We can work with you every step of the way, from learning more about psychological disease to insurance options to cover the cost of opioid addiction treatment.
Sources: Bakalar, Nicholas. “Alternatives to Opioids for Pain Relief.” The New York Times, November 2017. Accessed December 2017.
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