In 2017, the journal Pain Physician published findings regarding opioid misuse among the chronic pain patient population. The research stated that chronic pain and prescription opioid abuse are prevalent both in the United States and around the world.
This poses a conundrum for clinicians: You want to help reduce your patients’ pain. However, you know that opioid medications can be addictive and lead to lifelong, chronic issues of opioid misuse. What did the journal discover about how to work with opioids and when to avoid them?
Opioid Use for Pain Management Has Increased
While opioids have been used for acute pain such as pain from surgery, in the last two decades these drugs have been used more often for chronic pain as well. As a result, chronic use of these drugs has occurred, and patients who use these drugs are more likely to become dependent on opioids. Pain Physician found that the use of chronic opioid therapy for chronic non-cancer pain has increased dramatically over the past two decades.
Why has this occurred? According to the journal, there was a combination of factors that led to the overprescription of opioids:
- There was a cultural shift focused on the undertreatment of pain and the need for new methods of treatment
- New opioids became available and were easier for patients to take
- Drug manufacturers marketed opioids to clinicians
- Clinicians were not entirely aware of the addictive nature of these drugs
- Guidelines were biased in favor of opioid prescriptions
The Need to Use Screening Tools
Today, opioid misuse is a serious problem that has led to many deaths and many lives that have been impacted by misuse. When patients misuse opioids, there are significant implications for the health care system. The mean annual direct health care costs for patients who misuse opioids is 8.7 times higher than those of the general population. How can you reduce the impact of opioids on patients?
How do you know if a patient can manage to take opioid medication without problems with substance misuse? The Pain Physician report suggested that clinicians use a screening instrument that can provide a method of finding patients who are suited to opioid therapy. This instrument can help assess risk, find those who need more monitoring and assess potentially problematic drug-related behavior. During the time that people take opioids, the journal suggests that screening tools, such as urine tests, and treatment agreements be used to keep the patient’s behavior in check and monitored.
The journal also suggested prescribing the lowest possible dosage and limiting the availability of opioids by prescribing just a few days’ worth at a time.
Alternative Pain Management
What can a doctor do about a patient’s pain if they are concerned about potential addiction, but the pain still dominates a patient’s life? They may want to help but also do not need to create a new problem for the patient. It is wise to consider that there are many non-opioid pain management strategies to try. These include:
- Massage therapy, chiropractic care and physiotherapy
- Non-opiate painkillers like ibuprofen and acetaminophen
- Tricyclic anti-depressants and anti-epileptics for nerve pain
- Cognitive behavioral therapy to improve peoples’ ability to manage pain
These strategies can help people manage and improve their level of pain without opioids, reducing the opportunity for misuse.
At The Recovery Village Columbus, medical professionals focus on helping you co-create a better, stronger future for yourself and your family. If you deal with an opioid use disorder, contact The Recovery Village Columbus today.