Options for Pain Management Without Opioids
When you live with constant, unrelenting pain, even the smallest daily tasks can be excruciating. That’s why opioids exploded in popularity over the last decade or so, with Vicodin, Percocet, Demerol, OxyContin, and others becoming familiar brand names. These opium-derived prescription painkillers are powerful, with the double whammy capability of blocking pain signals from traveling up the body’s nerves to the brain while also producing a pleasurable, relaxed sensation.
However, as anyone who’s paid attention to the news knows, opioids have a dark side. These drugs can be highly addictive, and are easily misused. A tolerance to these painkillers can develop, which means you have to take more and more of them to get the pain relief and the pleasurable feeling. As you take the opioids more frequently, your dependence on them can grow, and you may eventually find it hard to function without them. The number of prescriptions, and the number of opioid-related deaths, has grown astronomically, so much so that the trend is often referred to as an “opioid epidemic.” The Centers for Disease Control and Prevention found that in 2013 alone, 249 million opioid prescriptions were written in the United States—and unfortunately, there are more than 40 deaths from opioid overdose every day.
This is a major reason why people dealing with addiction find it so difficult to treat pain. Because opioid use can quickly spiral from use to misuse to addiction, many people believe they have to avoid these medications entirely and suffer through the pain. While avoiding opioids is a wise choice, living in pain isn’t. It’s important to learn how to manage pain without opioids, and that’s a main reason why September has been named Pain Awareness Month.
This health observance was created in 2001 and spearheaded by the American Chronic Pain Association. The goal is to raise awareness about pain and pain management, and part of that is to be more informed about the different non-opioid options for pain. Using these techniques allows people with addiction to avoid using dangerous opioids while still alleviating their pain so they can live vibrant lives.
Here are some of the key ways that allow you to manage pain without opioids. One underlying concept with all of these methods is that you should find a physician that can work with you, understanding your desire to avoid opioids and helping you devise an alternative pain management plan. The American Chronic Pain Association offers some tools you can use to help you communicate your pain issues to your doctor so you can find a treatment plan that works best for you.
There are several different types of these medications that don’t have the addictive qualities of opioids and can be found in over-the-counter formulations as well as prescription strength. (Well-known OTC medications include forms of ibuprofen and acetaminophen such as Advil and Tylenol, respectively.)
For instance, anti-inflammatories can help ease the pain caused by arthritis or inflamed joints. Sometimes, antidepressants can be prescribed for pain management—they can help relieve pain as well as any related anxiety that stems from chronic pain. Anticonvulsants can be used for nerve pain, while relaxers ease muscle-associated pain. Aside from oral medications, topical analgesic patches can also offer relief by either numbing the affected area or acting as an anti-inflammatory.
It’s critical to note that, just as with opioid-based pain management plans, a physician should be overseeing any non-opioid medication treatment you undergo for pain to ensure dosage levels are correct and to watch for any potential side effects.
It may seem counterintuitive, but sometimes working your body through therapy or exercise can help bring much-needed pain relief and increase functionality to improve the quality of daily life.
Physical therapy can be an important tool in how to manage pain without opioids. A therapist can devise a treatment plan with exercises meant to strengthen the body, tailoring it to your needs. Their knowledge of the human body means they can take into account the effect pain has on your joints, muscles, bones, and tissues and work with you accordingly.
While physical therapy generally strengthens your body, occupational therapy can train you to adapt to certain tasks and functions you couldn’t do normally because of chronic pain. If you have a bad back, for instance, an occupational therapist can help you learn how to do certain activities in ways that won’t exacerbate the pain. In both types of therapy, exercises can be done with the therapist or on your own at home; they can also be integrated into a pain management plan with non-opioid medications or other treatments.
Mind and body pain management
There are many types of procedures that can bring pain relief and leave you feeling rejuvenated. Some treatments are simple, such as spending time in a hot tub or getting a massage. Others require a trained technician, such as acupuncture, where needles can be precisely placed to block pain signals from traveling to the brain.
It can also help to focus on mental health, not just physical health, when dealing with pain. Cognitive-behavioral therapy can give you the tools to help cope with the effects of chronic pain, while relaxation techniques such as meditation, biofeedback, and deep breathing can calm and soothe you, which can counterbalance the pain.
Instead of medication that is taken orally, nerve blocks deliver it in a different way. They act like a local anesthetic as they are injected into the spot where the pain exists in order to numb the area and diminish the pain. The nerve block may need to be re-injected for continual pain management, depending on your condition and the severity of your pain.
In recent years, there have been some interesting innovations in how pain is managed without opioids. For instance, pain signals can be interrupted with low-voltage electrical stimulation on the nerves. A nerve can also be manipulated via radio waves that disable it for roughly a year.
Two other procedures involve implantation of a pain management device. One involves putting a device in the lower back area that can be operated via remote control to trigger a tingling sensation whenever pain occurs. A pain pump can also be implanted in order to inject medication to the spinal cord.
If you have been using opioids for pain and have developed a dependence, or worse, don’t wait to get help. A comprehensive rehabilitation program can give you the tools to recover from an opioid use disorder, and get you on track with a pain management program that uses non-opioid treatments to give you the needed relief from chronic pain.
Dr. Sola is one of the world’s leading experts in medically-based ibogaine treatment; he has more clinical experience with safe and effective ibogaine administration than any other M.D. in the world today.