Living With Chronic Pain? Learn Some Safer Alternatives to Opioids

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
May 25, 2016
Why are opioids dangerous?

After pop music icon Prince died at 57, media reports linked his death to painkillers, specifically opioids. And while no official cause of death has been released, prescription painkillers are still dominating stories about the singer’s death and drawing attention to an epidemic of opioid overdose.

Deaths from prescription opioids, such as oxycodone (Oxycontin, Percocet, Percodan) and hydrocodone (Vicadan), have quadrupled since 1999, according to the U.S. Centers for Disease Control and Prevention. There were 28,000 deaths from opioid overdoses in the U.S. in 2014. Half were from prescription opioids; heroin overdoses accounted for the remainder, according to the CDC. For people over 50, the risk of hospitalization or death from such overdoses is rising much faster than for the general public, according to the U.S. government’s Agency for Healthcare Research and Quality.

Opioids, a class of narcotic medications that provide pain relief, are commonly prescribed for short-term and chronic pain. In fact, prescriptions for the pain relievers have also quadrupled since 1999, the CDC says. They are prescribed for many different types of pain, but particularly for pain that is too strong for over-the-counter pain relievers such as acetaminophen, aspirin or ibuprofen.  

According to National Institutes of Health/National Institute on Drug Abuse, the most frequently prescribed opiates include morphine (Kadian, Avinza) and codeine; while, most prescribed opioids are oxycodone (Oxycontin, Percocet, Percodan) and hydrocodone (Vicadan).     

Because opioids are similar in structure to our brain’s neurotransmitters, the chemical messengers that function as our body’s natural painkillers, they latch on to receptors throughout our body. Once attached, opioids mimic neurotransmitters and send signals to the brain to reduce the intensity of pain and ease depression.  

When used as directed by a physician, they can be effective; side effects include drowsiness, mental confusion and nausea. However, long-term opioid use can lead to dependence, and there’s growing evidence that it can actually reduce their effectiveness, leading to a “chronic pain state,” according to the National Institutes of Health Office of Disease Prevention. Worse, dependence can lead to abuse, and when abused, opioids can severely depress the respiratory system, resulting in death.

“It is, unfortunately,  all too easy for patients who have been injured or undergone surgery to become addicted to opioid pain killers,” explains Bernard Kaminetsky, MD, medical director, MDVIP. “This is why I always tried to find safer alternatives for my patients.” If you are living with chronic pain and taking opioids, work with your doctor to develop a pain management plan. Your doctor may:

Prescribe different medications. Anti-depressants (serotonin and norepinephrine reuptake inhibitors or SNRIs), for example, can block the absorption of certain neurotransmitters, which seems to elevate mood, reduce anxiety and ease pain. Anticonvulsants can help control pain by blocking pain signals from the central nervous system. And corticosteroids can inhibit damaged nerves that cause pain. Like opioids, these medications also have side effects, ranging from joint deterioration to psychiatric issues.

Suggest alternative pain therapies. Massage can help reduce pain associated with tight muscles, release neurotransmitters and foster better sleep. And acupuncture can provide a calming, restorative effect on the body that helps reduce pain.  

​Recommend exercise. Yoga and Tai Chi can help improve functionality and mobility; ultimately, reducing pain. Physical therapy can help improve posture, heal injuries and strengthening weak muscles, helping to relieve pain. And stretching can help alleviate musculoskeletal pain that is associated with or exacerbated by tight muscles.

Your physician may also recommend neurostimulators, which involves implanting electrodes to interrupt pain signals and provide relief from back, neck, arm and/or leg pain.

If you are regularly using an opioid to control chronic pain, work with your MDVIP-affiliated doctor. They have the time to partner with you to develop a customized action plan. They can also help you access one of our Medical Centers of Excellence — 16 nationally renowned medical institutions that we’ve partnered with to enable an easy connection with the experts at these institutions to help you get a second opinion, consultation or specialized treatment whenever needed. Click here to learn the benefits of an MDVIP-affiliated doctor and how they can help with chronic pain management. 

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About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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