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Opioid Alternatives: A Guide to Safe Usage

Opioid medications are most commonly prescribed for pain relief, though they have also come to be widely misused recreationally. Legal opioid pain relievers include OxyContin, Vicodin, codeine, and morphine. These medications are meant to be closely managed by doctors who prescribe them, yet many people find ways to misuse them. Illegal forms of opioids include heroin and fentanyl.

People like opioids for medical and recreational purposes because of the pain-relieving and calming effects they produce. When taken in high enough dosages, it is possible to experience a high of extreme euphoria.

While prescriptions are meant to restrict access to opioids, people find ways of obtaining excessive amounts of them, such as receiving prescriptions from multiple doctors at once, getting opioids from friends or family members with a legal prescription, or buying opioids illicitly off the street.

No matter where they come from, all opioids interact with opioid receptors in the brain and body that are responsible for sending pain messages. Opioids block sensations of pain as well as produce sensations of euphoria. This combination makes opioids appealing to people who may misuse them.
The National Institute on Drug Abuse (NIDA) warns that regular use of opioids can lead to dependence, addiction, overdose, and death. Even when they are used under a doctor’s supervision, opioid misuse is common and can lead to many complications.

The Opioid Epidemic

Understanding why people like opioids so much can help you grasp how the opioid epidemic took shape in the United States. A combination of opioids that provides powerful pain relief and doctors overprescribing them has led to the opioid overdose crisis, which was declared a public health emergency in 2017. Both legal and illicit use of opioids has fueled the development of the problem.

Opioid use increased significantly in the 1990s when pharmaceutical companies reassured medical providers and the public that opioids were not addictive and were a safe option for pain management. Trusting these companies, doctors began to prescribe opioids more and more frequently. As we now know, opioids are highly addictive, and as a result of so many prescriptions being written, as well as general acceptance about the efficacy and safety of opioids, millions of people began to use them and then misuse them.

Opioid misuse has increased exponentially over the past 20 years. In 2015, more than 33,000 people in the U.S. died from an opioid overdose. The most common opioids being misused include prescription opioids, heroin, and fentanyl.
Experts estimate that 2 million people struggled with a prescription opioid use disorder in 2015. Currently, 115 people in the U.S. die every day due to an opioid overdose. It is estimated that prescription opioid misuse costs the economy $78.5 billion per year in costs related to health care, lost job productivity, addiction treatment, and involvement with the criminal justice system.

Risks Associated With Opioid Use

One of the greatest risks associated with opioid use is the risk of misusing them, whether intentionally or not. Even when obtained through a doctor’s prescription and when used as directed, misuse is possible. NIDA estimates that 21 percent to 29 percent of people who are prescribed opioids to help manage chronic pain end up misusing them. Of the people who misuse their prescription opioids, about 8 percent to 12 percent develop an opioid use disorder.

Addiction can happen to anyone, but there are risk factors that can contribute to developing an opioid use disorder. Addiction does not happen overnight, though it can develop relatively quickly. If you are aware of your risk factors, however, you may be better prepared to properly address warning signs if and when they arise.

Risk factors for developing an opioid use disorder include:

Risk Factors for Developing Opioid Use Disorder

  • Consuming opioids by snorting or injecting them
  • Taking opioids for longer than recommended or longer than you intended to
  • Family or personal history of substance misuse
  • Regular contact with high-risk environments for substance use
  • Work or family problems
  • Unemployment or other job issues
  • A tendency for risk-taking behavior
  • History of depression or anxiety
  • History of other mental illness
  • Poverty
  • Stressful life circumstances

Alternatives to Opioids

In response to the opioid epidemic, many health care companies and government agencies have been making efforts to raise awareness about safer alternatives for pain management. The U.S. Department of Health and Human Services (HHS) announced a plan in 2017 for combating the opioid crisis. In addition to improving access to treatment and maintaining better public health surveillance, HHS pledged to support further and better research on pain and addiction as well as promote better practices for pain management.

The American Society of Anesthesiologists has recognized many non-opioid treatment options for acute and chronic pain. Millions of people suffer from various forms of pain each year, and many of them can find relief through means other than prescription opioids such as:

Alternatives to Opioids

  • Prescription or over-the-counter aspirin, ibuprofen, and acetaminophen
  • Physical therapy
  • Massage
  • Acupuncture
  • Steroids
  • Surgery
  • Injection of local anesthetics

Many people can find relief through any one or a combination of the above treatment options. If your goal is to avoid taking prescription opioids, speak with your doctor about making a holistic pain management plan. A combination of over-the-counter medicines used as needed with physical therapy is a much safer treatment method that can be used safely for long-term pain management.

If the above treatment methods are not enough to relieve chronic pain, scientists and pain management experts have developed high-tech methods of pain relief, which include:

High-Tech Pain Relief Methods

  • Radio waves
  • Nerve blocks
  • Electrical signals
  • Spinal cord stimulation
  • Pain pumps
  • Stem cell harvesting

Are Alternative Me4dications Likely to Be as Effective?

Depending on your specific pain symptoms, alternative medications and treatments may be just as effective at managing your pain as prescription opioids. Many people report experiencing relief through interventions such as physical therapy and massage alone. Likewise, people who struggle with more severe pain or chronic pain have reported significant pain relief or complete treatment of their pain through more extensive medical intervention, such as radio waves or nerve blocks.

One reason some people may be resistant to exploring alternative pain treatment methods is that they can take longer to take effect than prescription opioids. Prescription opioids are likely to provide pain relief within minutes or hours, while options like physical therapy, acupuncture, or injections are likely to take multiple sessions to make a significant impact.

Although alternative pain treatments may take longer to take effect, they can be used safely for a much longer time and are more likely to get to the root of the problem. Opioids are effective at blocking pain signals being sent throughout the body, so your perception of pain goes down. They do not, however, treat the issue that is causing your pain. Opioids are highly effective at managing symptoms, but they are not effective at actually treating the root causes of pain.

Physical therapy and massage may be uncomfortable or slightly painful even, as you work to address the causes of your pain.

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A back that is out of alignment can cause significant discomfort for years until it is put back into place and exercises are carried out to reinforce and maintain your body’s structural integrity. It can be challenging to complete some of these physical exercises, but your body will build strength over time. No amount of opioids can make structural changes to your body that will alleviate pain for good.

How to Use Opioids Safely

Though opioid use is risky, it is possible to use them safely. You must be disciplined about your opioid use and only take them exactly as prescribed by your doctor. The Mayo Clinic recommends using opioids for a maximum of three days to reduce the risk of misuse. Opioids are most appropriate for the treatment of acute pain following an accident or surgery. The lowest dose needed should be taken for the shortest amount of time.

If you are struggling with chronic pain, opioids are not likely to be your best treatment option. The risk of experiencing adverse side effects and developing a substance use disorder is too great. Medication to manage your pain is still an option, as there are many much less addictive medications available as well as therapies that do not involve pharmaceutical drugs at all.