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Pain Management Strategies to Avoid Opioid Use

Opioids have been the subject of much scrutiny in the past few years as a result of the opioid crisis that’s affected the United States and the world. According to the American Psychiatric Association, an estimated two million people had substance use disorders related to prescription opioids. Between the abuse of prescription opioids and illicit drugs like heroin, millions of people have died in fatal overdoses. In 2016, 42,000 people died in overdoses that involved opioids. Though there are a variety of problems that have contributed to the opioid crisis, including an influx of illicit heroin and other opioids from transnational criminal trade, many believe that limiting opioid prescriptions can help stem the problem.

However, opioids are very effective pain-relievers. When you experience pain, your neurons send signals from the site of pain to the spine, and then to the brain. Opioids bind to receptors on those neurons to block both the sending and receiving of pain signals. Opioid receptors are located at every point in the pain trail to the brain. However, opioids are also notoriously addictive. Prolonged use, high doses, and abuse increase your likelihood of experiencing chemical dependence and addiction. Because there are some very serious risks that come with opioid abuse and addiction, researchers and medical professionals have been exploring other pain-management options.

But there are other reasons to look for alternatives to opioids. Opioids come with a variety of adverse side effects that can complicate things like post-surgery recovery or cancer treatment where opioids are commonly used. A 2005 paper on the changing role of non-opioid pain relievers in treating post-operative pain said, “The opioid-sparing effects of these compounds may lead to reduced nausea, vomiting, constipation, urinary retention, respiratory depression, and sedation. Therefore, the use of non-opioid analgesic techniques can lead to an improved quality of recovery for surgical patients.”

Pain is a fact of life, especially when certain diseases, injuries, and surgery are involved. However, finding alternatives to opioids in relieving that pain may help you avoid some serious problems, including addiction. Learn more about opioid alternatives.

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Non-Opioid Medications

There is more than one pharmacological method to treat pain. Opioids treat pain directly by stopping pain signals from reaching the brain. For that reason, it has been a go-to method for doctors whose patients are in pain. But other drugs can go after some of the factors that are causing pain like inflammation, stress, and spasms. Here are some pain relieving medications your doctor might try with you: 

Anti-inflammatories

These are some of the most common pain-relief medications in the United States. In fact, you may have one in your medicine cabinet right now. Ibuprofen, or Advil, is a nonsteroidal anti-inflammatory drug that’s used to treat pain, fever, and inflammation. When you sustain an injury, white blood cells and other chemicals increase and move into the area to protect against infection. This also floods the area with blood and other fluids that are bioproducts of some of these chemicals. The influx of blood and fluid causes redness and swelling. This swelling can irritate nerves which causes pain. Controlling inflammation can help relieve some pain. Ibuprofen, naproxen, celecoxib, and aspirin are all approved medications that can help alleviate inflammation.

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Anticonvulsants

Anticonvulsants are used to treat muscle spasms and epileptic seizures, but they can also calm nerves that can lead to neuropathic pain. Nerves that are damaged by injuries, alcoholism, toxins, certain diseases, and surgery can lead to painful symptoms. Anticonvulsants can slow the nervous system down which can ease nerve pain. 

Cannabis

Research has shown that marijuana can be helpful in treating pain, especially pain that’s difficult to treat. It’s commonly used in cancer treatments to mitigate nausea that’s caused by chemotherapy. But studies have also shown that it may block peripheral nerve pain, which are nerves that run throughout your body. Plus, cannabinoid receptors run throughout the body and in the peripheral nervous system. 

Physical Therapy

Physical therapy can help you fight pain by helping to preserve or improve your strength and mobility. You may be able to increase flexibility and muscle support to help you move, walk around, and work without pain. Occupational therapy can also help you learn how to effectively accomplish daily tasks with less pain.

Exercise

Pain symptoms are often worsened overtime by something that’s referred to as the vicious cycle of pain. Pain may cause you to avoid certain activities that bring you joy and exercise. That can decrease your mobility and cause depression. A sedentary lifestyle can lead to more stiffness in the body as well as other health issues. Plus, depression and stress have shown to cause pain. When you’re experiencing pain, the last thing you want to do is to get up and go to the gym. However, exercise can elevate your mood, lower your blood pressure, and even release natural opioids called endorphins. 

Anti-inflammatory Diets

Certain foods can cause inflammation like sugar, flour, and dairy. A diet that’s designed to limit inflammatory foods in favor of neutral and even anti-inflammatory foods. There are several dietary options to choose from, including the ketogenic diet. Though the keto diet was originally designed to treat epilepsy in children, it has shown to have several other health benefits, including anti-inflammatory capabilities. However, if you’d like to take a simpler approach, you can try identifying and limiting a few inflammatory foods you usually consume. You can also increase your intake of other anti-inflammatory items like green-tea and turmeric. 

Cold and Heat

Believe it or not, the age-old pain remedy that has been passed down by high school coaches for generations is actually a fairly effective method. Cold and heat compresses can help reduce swelling and relax sore muscles. Applying an ice pack to an injury can help reduce inflammation and swelling because blood flows away from the cold. Heat stimulates receptors in a given area which can reduce the pain signals sent to the brain. A warm shower and an ice pack for 15 minutes can go a long way in promoting healing and relaxing the muscles in a given area. However, don’t ice for too long or too frequently. Too much ice can restrict blood flow to the point where it can’t help heal the affected area.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a common therapy in addiction treatment, but it can be applied to a wide variety of psychological issues like depression and anxiety. While that may sound like it can’t help physical pain much, it’s worth noting that stress, anxiety, and depression can cause very real pain symptoms. Anxiety attacks can cause chest pain, depression can worsen pain symptoms, and stress is linked to a wide range of illnesses. CBT can help identify triggers and help you develop positive coping mechanisms.

Sources

American Psychiatric Association. (n.d.). Nearly One in Three People Know Someone Addicted to Opioids; More than Half of Millennials believe it is Easy to Get Illegal Opioids. from https://www.psychiatry.org/newsroom/news-releases/nearly-one-in-three-people-know-someone-addicted-to-opioids-more-than-half-of-millennials-believe-it-is-easy-to-get-illegal-opioids

Salleh, M. R. (2008, October). Life event, stress and illness. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341916/

Pinto, A., Bonucci, A., Maggi, E., Corsi, M., & Businaro, R. (2018, April 28). Anti-Oxidant and Anti-Inflammatory Activity of Ketogenic Diet: New Perspectives for Neuroprotection in Alzheimer's Disease. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981249/

Shpaner, M., Tulipani, L. J., Bishop, J. H., & Naylor, M. R. (2017, August 08). The Vicious Cycle of Chronic Pain in Aging Requires Multidisciplinary Non-pharmacological Approach to Treatment. from https://link.springer.com/article/10.1007/s40473-017-0126-5

White, P. F., PhD. (2005, November). The Changing Role of Non-Opioid Analgesic Techniques in the … : Anesthesia & Analgesia. from https://journals.lww.com/anesthesia-analgesia/Fulltext/2005/11001/The_Changing_Role_of_Non_Opioid_Analgesic.2.aspx

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