There’s an opioid crisis going on in America and most of us don’t even realize it. With increasing reports of chronic pain over recent years, Americans are searching for something to take the edge off. The easiest, most convenient solution? Opioids. The problem? We’re consuming more of them than ever before.
What Are Opioids and Why Are They Bad?
Simply put, opioids are painkillers. They include prescription drugs like codeine, morphine, hydrocodone, oxycodone, methadone, and fentanyl.
These drugs are used often in treating acute moderate-to-severe pain because they can provide immediate relief.
They are also commonly used in treating chronic cancer pain.
Problems occur when you develop a tolerance to the drug over time. Once this happens, to get the same desired effects you had at first, you have to increase the dosage. This can lead to increases in side-effects and…
Over time you can even develop a physical dependence to the drug. If you suddenly stop taking it, you will get withdrawal symptoms, which include pain, irritability, nausea, and tremors.
Long term opioid use can then lead to opioid-induced hyperalgesia, which causes a patient to have increased sensitivity to pain – the opposite of what the medication is intended for.
It’s a vicious cycle.
The Crisis Is Right Outside Your Door
Don’t overlook these very real scenarios. We all learned in Junior High what can happen when we depend on drugs. But we think it only happens to deviants. Unfortunately, the problem is more widespread than that. It’s likely even happening with people you know.
For many, opioids have become a part of life, like brushing your teeth. I can’t tell you how many patients I see who tell me they take a pain pill in the morning and one again in the afternoon to “get through the day.” Oh, and then one more to be able to sleep at night.
I had a recent patient who has had low back and hip pain for 25 years. She told me she has been taking opioids 2-3 times per day, every day, over that span of time. I wish I could tell you this was an isolated incident, but it is a regular occurrence.
I won’t get into addiction and how overdoses can kill. Although this is part of the crisis in America, the problem starts before we get there. Therefore, so must the solution.
2 Sides of the Opioid Problem
The problem as I see it is twofold. On the one hand, we have an increase in opioid production from pharmaceutical companies and hospitals are funding them. According to the American Hospital Association, total annual spending on prescription drugs is $309 billion – the fastest growing segment of the US Health Care Economy.
The hospitals are buying them because we are demanding them. In fact, according to the International Narcotics Control Board, of all the Hydrocodone (NORCO) produced in the world, Americans consume 99%.
This is a big problem.
The other side of the problem – and what I believe is the root of it – is that we Americans aren’t willing to take action for our own wellbeing. We’ve become a passive culture looking for the quickest, easiest solution to our problems. We’ve become victims of our pain, blaming its continuation on external sources and, therefore, looking for external sources to “fix” it.
With these 2 sides of the problem: the increased production of opioids and the passive mindset of Americans – we have 2 potential solutions…
2 Potential Solutions to the Opioid Crisis
One solution is to instruct hospitals and physicians on proper opioid prescription methods. The Center for Disease Control (CDC) has recently put into place guidelines for opioids for this very purpose. They state that non-opioid therapy is preferred for treatment of chronic pain (thank goodness). Here are some more highlights from their guidelines:
- Clinicians should only prescribe opioids when benefits are expected to outweigh risks
- Clinicians should establish treatment goals with patients and discuss how opioids will be discontinued
- Clinicians should prescribe the lowest effective dose and increase dosages with careful assessment
- Clinicians should evaluate continued opioid therapy with patients every 3 months or sooner
Now, these are just guidelines. I’m not really sure whether or not clinicians are being monitored regularly, if at all, for compliance with these guidelines. Although there are steps in place, it becomes a matter of following them.
The other solution is in the hands of the American people – the consumers and those who educate and treat them.
It comes down to you and me.
We all learned from economics class that, if the demand for a product decreases, the supply will also decrease. If we aren’t asking for painkillers, we won’t be prescribed them. If clinicians aren’t prescribing them, hospitals won’t buy as many and drug companies won’t make as many.
So, how do we decrease the demand?
We need to take ownership of our lives and become active participants in our path toward wellness. No more passive reliance solely on external sources to do the job for us. It’s time we take matters into our own hands.
We need to make conservative care the first course of action.
Recommendations for Acute Pain Management
If you’re having an upcoming surgery, it’s likely you will be prescribed opioids in the recovery process. Speak to your surgeon ahead of time about a plan of action for appropriate dosages, when and how you will taper off.
Make sure you are getting the proper rehabilitative treatment to physically recover from surgery. Give physical therapy all you’ve got. You must be an active participant in your recovery.
Recommendations for Chronic Pain Management
If you are currently relying on painkillers to make it through each day, my recommendation would be to talk to your physician about slowly tapering off. As we’ve seen, stopping suddenly can cause painful withdrawal symptoms that may lead to recurrence of using. We don’t want this. Take it slow.
My next recommendation would be to seek conservative treatment. The patient I mentioned earlier who has been taking painkillers for 25 years also told me she hadn’t been to physical therapy before. Again, this isn’t an uncommon occurrence. I don’t understand how, but far too often PT is under-utilized in cases of acute and chronic pain. Oh, and by the way, her pain significantly decreased after just one PT session.
Physical Therapy can offer education and support about what pain is, why you are experiencing it, and how to manage it. We can identify areas that may need more mobility or strength to get you back to better function. We can also help you reclaim your life by teaching you to move again in ways that are non-harmful and even therapeutic.”
Help Make the Opioid Crisis a Thing of the Past
The opioid crisis in American is very real. It is happening every day, everywhere you look, whether you realize it or not. Opioids have their time and place, but that time is short and that place is small.
The problem isn’t the corruption of hospitals and drug companies; the problem is with you and me. The Solution, therefore, is with you and me.
We must stop being passive when it comes to our health. We must change our mindset and take ownership of our future.”
Question: How can you help yourself or someone you know take their life back from opioids? You can leave a comment by clicking here.