Living with Chronic Pain? Learn Some Safer Alternatives to Opioids

After pop music icon Prince died last month 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. If you or a loved one needs an MDVIP-affiliated doctor,  click here to locate one. 
May 8th, 2017
Why is there no mention of the use of high doses of Vitamin C which has a history of eliminating pain and the need for pain meds? The literature goes back more than 50 years indicating studies and successes!
Apr 20th, 2017
I don't think pain relievers are the real problem its a mind set.If used and not abused they give most people their lifestyle back.I know for a fact if it wasn't this it would be something else. WE ARE individuals but some where we have become a classification. NOT FAIR........
Robert Gaston
Dec 17th, 2016
What classification of Drugs is Tramadol and does it have same addictive qualities as opioids
Dec 16th, 2016
Those of us, like Robert, who have legitimate debilitating pain, who have worked hard to find a perfect recipe that allows us to be functional members of society, are living with dread as we await the decisions of those who think smashing their thumb is pain. I am able to work in a well respected job BECAUSE I am able to take pain medications. I take exactly the same amt each day ---- never more, sometimes less, but mostly try to stick to the schedule. I have never had to increase the dosage. With Lyrica, cymbalta, and hydrocodone, I do very well. It's the perfect recipe for my nerve pain, and was years in the making. Yet others think they know more than I do what I am feeling and what is best. Honestly, if legislation goes through to decrease availability of these medications, we will find ourselves enjoying the role of effectively torturing our elderly for their last miserable years.
Alicia Oliver
Sep 21st, 2016
Cymbalta at 120mg a day keeps my pain under control. I have a very high tolerance to pain,but it started making my life miserable and to top it off I am allergic to most all pain medications so I was so happy that Cymbalta worked for me. I feel so sorry for people that become dependant on
opioids... I have seen love ones go through horrific withdrawals when trying to detox. I pray that Abba delivers you without much suffering.
robert luckert
Sep 21st, 2016
I've been on narcotics, Oxycotin 60mg & 20mg QD also 600mcg Actiq ( Fentanyl ) QD, for over 20 yrs. Now with insurance problems they are making me come off all pain meds. I'm starting the waning process this week, coming down 25% to 50% every week for 4 weeks, until I'm off. I have very serious acute pain that starts in my back and goes down to my feet. I walk with a serious limp because of numbness in my foot sometimes. I underwent surgery on my back and didn't go very well. I understand about the seriousness of pain meds, but what happens after rehab with the pain.I take my meds as prescribed and don't abuse them How can an insurance know more than doctors? I've been off my meds 2 or 3 days at a time, when the insurance wouldn't okay them for Walgreens in a timely manner. Not only pain meds, but also psychiatrist meds have been late and believe me I know about withdrawal.
1 Reply
Sep 21st, 2016
Greetings Robert.

We’re sorry to read that you are in so much pain. Our best advice for you is to continue working with your doctor to find alternatives to opioid medications that can provide you with pain relief.

In good health,

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