According to the National Institute of Health (NIH), at least 11 percent of Americans suffer from various forms of pain that they experience every day. Because of this, a lot of medical practitioners have focused their direction towards pain management. Unfortunately, the rise in the need for pain relief has given birth to a different kind of problem: opioid abuse.
People experience pain differently because this is based on the individual’s perception of pain. The level of pain felt by one person may be aggravated when going through difficult times, anxiety, or depression.
In this article, we will discuss pain management, what we can do to treat or alleviate pain safely, and why opioid abuse has become an epidemic all around the world.
What is pain management?
Pain management is a specialized medical treatment that deals with pain of different origins – spinal, neuropathic and musculoskeletal pain disorders. It is the primary concern of doctors to provide immediate intervention to reduce the severity of pain being experienced by individuals. Physicians may recommend or prescribe different kinds of techniques for pain management.
What is the primary role of pain management physicians?
Pain management physicians, as the name implies, are specialized doctors who help manage pain that individuals may be suffering from.
A physiatrist – and yes, that’s not a misspell of “psychiatrist” – is a rehabilitation medicine physician who helps alleviate pain suffered by any patient, may it be related to nerves, muscles, or bones. These doctors can help treat injuries or other illnesses that may affect the normal movement of an individual.
Meanwhile, an anesthesiologist is a trained health professional who treats patients suffering from chronic pain by using a wide range of procedures or medications.
Physicians may undergo specialize training on pain management to have an in-depth knowledge about the physiology of pain and to be able to properly diagnose patients through specialized tests.
Pain Management Procedures and Techniques
Pain management covers a wide variety of procedures that patients suffering from mild to severe pain may receive. Apart from medically prescribed opioid medication, doctors may have the following options to help alleviate pain, such as the following:
- Regenerative therapy
- Radiofrequency ablation and treatment of various nerves
- MRI device implantation
- X-ray-guided spinal and joint injections
- Spinal cord and peripheral nerve stimulation
Highly skilled physicians are the only ones who can perform these techniques.
Proper pain management approaches
Giving the proper pain management involves being able to determine the cause of the pain being experienced by the patient. With appropriate review of the case, the best pain management option may be provided as soon as possible.
Managing pain should not be focusing solely on treating the body, but it should also include the treatment of the mind. There are a lot of pain medicines that may be prescribed to patients suffering from pain. Some of these include the following:
- Anti-seizure medications
- NSAIDs (non-steroidal anti-inflammatory drugs)
Other pain management options are as follows:
- Heat and cold therapy
- Visual imagery
- Transcutaneous Electrical Nerve Stimulation Therapy
Prescription Opioids Abuse
The most commonly abused drugs include stimulants, CNS depressants, and opioids, the latter of which have become the subject of much scrutiny by the medical field and the general public. A large number of Americans have become dependent to opioids to treat their pain, and this has led to a higher risk of opioid abuse.
Despite the government’s call to fight drug addiction, people still continue buying drugs from the black market for recreational use. Among the commonly abused substances include morphine, heroin, and prescription pain relievers.
Some users started out as patients who have been prescribed opioids for their pain management needs. However, over-prescription has led to opioid abuse and addiction. The rewarding effect of opioids can be increased when the drug is used rapidly and frequently.
The most commonly abused opiates include the following:
It is unfortunate how some teenagers have gained access to prescription opioids from their own parents who may have been prescribed to take the medication. Some reports say that some clinics have been robbed of these specific drugs, which are sold in the streets.
Some of the reasons why opioids have become one of the popular choices among drug users are as follows:
- It’s commonly prescribed by doctors.
- Use of the drug is socially acceptable because it is designed as a means to help treat pain.
- Pharmaceutical companies use aggressive marketing techniques to encourage vulnerable individuals to use it.
Facts and figures on opioid abuse
Substance abuse is costing world governments a huge sum of money. With regards to illicit drugs alone, the U.S. government spends roughly $11 billion for health care costs.
Opiate abuse accounts for a great proportion of the government’s drug abuse problem. There has been a rise in the number of deaths linked to prescription opioid use since the early part of the 21st century. In 2002, opioid analgesics have become one of the most common causes of death.
Some individuals choose to use opioids over morphine and heroin due to affordability and accessibility.
The effect of opioids may be heightened when pills are crushed, injected or when taken in combination with another drug. People taking these opioids more than the dosage required may succumb to opioid addiction.
More than 100 million Americans suffer from chronic pain, and most of them are under opioid therapy. Among this number, at least 38 million suffer from back pain and approximately 17 million are suffering from osteoarthritis. Considering that pain management may last for several months, scientists are still debating on whether the long-term use of opioids is more beneficial than being a risk for drug dependence.
Patients suffering from chronic pain may need to be treated for a longer period of time. In some cases, there is a need to increase the dose up to 10 times to maintain the level of pain relief needed.
Opiate addiction is likely to happen when an individual no longer feels the kind of “high” that he wants to achieve. The next logical step for these individuals is to take larger or more frequent doses until they are able to achieve the euphoric results that they are looking for.
Signs of Opioid Abuse
Opioids are pain killers that are most commonly prescribed to help treat pain. However, when these drugs fall into the wrong hands, there is a high risk of being abused.
The short-term effects of opiate use are the following:
- Feeling of euphoria
- Pain relief
Opiates initiate the release of dopamine in the brain, thereby creating a feeling of extreme pleasure. Unfortunately, opiate use may produce unfavorable effects on certain individual, which include:
- Intermittent nodding or loss of consciousness
- Respiratory depression
- Social withdrawal
One of the very common signs of prolonged opiate use is having smaller-sized pupils.
Meanwhile, long-term use of opiates can cause the following:
- Abdominal distention
- Brain damage
- Development of tolerance
- Liver damage
Some users would crush opiate pills, mix them with water and alcohol, and then inject the concoction into their bloodstream. This practice may cause heart problems as well as pulmonary embolism. Additionally, if the injection site is infected, it may result to gangrene.
Other effects of opiates abuse include lower immune system, risk of gastric problems, and potential development of cumulative hypoxic end-organ injury.
Teen Opiate Abuse
Vicodin and Oxycontin are two of the most common opioid medications abused by teenagers. According to a report by the National Institute on Drug Abuse (NIDA) in 2014, about 8 percent of high school seniors have used Vicodin. It also said that teens are likely to combine opiates with alcohol to heighten the effect, which leads to more dangerous effects such as severe respiratory depression.
Continued use of opiates may lead to tolerance, which may force the user to take more doses than usual.
Just like taking any kind of illicit drug, habitual use of opioids may lead to dependence. Dependence on the drug may be confirmed through the following signs:
- The user ignores the consequences despite knowing them.
- The individual starts stealing from others just to be able to buy the drug.
- Relationships may be affected.
- Performance in school or at work may be observed to be poorer than usual.
Failure to stop drug use may warrant the help of a rehabilitation center.
It is important to note that there is a possibility for opiate overdose. For this case, some emergency centers administer Narcan, a nasal spray that is primarily used to help the patient recover from difficulty in respiration. However, it is not considered a treatment for opiate overdose; it is used only as an emergency aid before the actual medical intervention.
Treatment for Opioid Addiction
When dealing with addiction treatment involving opioids, physicians and rehab centers may ask for the following information:
- The length of time that the drug has been taken
- The last intake of the drug
- The source of the drug
Treating any type of drug addiction may involve detoxification, a process of reducing the abused drug until the individual no longer experiences withdrawal symptoms. This process usually takes several weeks to a few months, preferably in a rehabilitation center under the supervision of professionals.
Pharmacological treatment may be another option. The drug of choice to help opiate users to get over the addiction is either buprenorphine or methadone. The dose will be decreased each day until the effects of the abused drug wears off.
Withdrawal symptoms are likely to happen when a drug user has stopped taking the illicit substance. Such symptoms include:
- Inability to sleep
In the treatment of a recovering addict, residential rehab or outpatient therapy may be offered. The choice would depend on the individual’s level of opiate use, the amount of insurance coverage, the presence of family support, and any previous attempts to recovery.
During the therapy treatment, recovering users are taught a number of coping skills so that they can resist the temptation of getting hooked on the drugs again.
In the event that the individual has recovered from opioid addiction, it is highly recommended that the person undergoes an extended form of therapy such as counseling and support group sessions. This can help the individual to easily get back to his normal life.
More importantly, this kind of therapy can be made more successful when family members participate. In cases of addiction recovery, there is a need for loved ones to understand the kind of journey that the individual has gone through.