Tackling chronic pain and opioid epidemic by reducing prescriptions

Tackling chronic pain and opioid epidemic by reducing prescriptions

Drug addiction not only occurs out of dependence on illicit substances, but can be a result of opioids prescribed by physicians to help manage chronic pain that may arise due to a back or a leg injury. Opioids act on the nervous system to relieve pain by attaching to brain receptors. It thereby reduces the transmission of pain messages to the brain, spinal cord and other parts of the body, and increase the levels of feel-good hormone dopamine, which produces an intense feeling of ecstasy. 

However, long-term opioid use can have a negative impact on the body and mind. It can lead to addiction as the individual craves for higher doses to maintain the state of relief and feeling of well-being. Currently, the level of opioid addiction in the country has reached a very alarming rate, where more than 33,000 people died due to opioid overdose in 2015. The current state of affairs is believed to be an outcome of the high opioid prescription rate from 1999 to 2013 when nearly a quarter of a billion opioid prescriptions were written in 2013 alone.

Tapering off opioids for better quality life

Looking at the growing epidemic of opioid use and abuse, the Centers for Disease Control and Prevention (CDC) released guidelines for prescribing opioids to treat chronic pain in 2016. It clearly stated that if treatment goals are not met or opioids are no longer needed or if the “benefits do not outweigh risks,” they are to be discontinued or doses are tapered keeping patient’s health and safety in mind.

The idea of tapering the use of opioids in order to improve the chances of a better life for patients fall in line with a study that was published in the journal Annals of Internal Medicine on August 1, 2017, which recommended reducing long-term opioid therapy (LTOT) for chronic pain when the risks exceed the benefits. The researchers evaluated 67 studies comprising more than 12,000 patients to gauge the effectiveness of pain management methodologies like buprenorphine-assisted programs, behavioral therapy programs, ketamine-assisted dose reduction programs, acupuncture, exercise and counselling. The authors assessed evidence quality using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system where the pre-specified patient outcomes were pain severity, function, quality of life after reduction in prescribed dose, opioid withdrawal symptoms, substance use and adverse events. The studies included 11 randomized trials and 56 observational studies of which the quality of three studies was found to be good, fair for 13 studies and poor for 51 studies and though most studies reported dose reduction, the rates of opioid reduction varied across all interventions. Of the 40 studies that were followed up to evaluate the outcome after dose reduction, improvement was reported in pain severity in eight out of eight fair-quality studies, function in five out of five fair-quality studies and quality of life in three out of three fair-quality studies.

The findings suggest a new way for strategizing preventive measures and treatment procedures that would help fight against the opioid epidemic plaguing the country. According to Tamara Haegerich from CDC, “This study provides needed information for providers about how to taper and/or discontinue opioids safely and effectively — that is, with nonopioid treatments, slow reductions in opioid dosage, patient buy-in, and close monitoring.”

Do not delay treatment

In some of the clinical settings, doctors may not have access to behavioral therapies or any other alternate mode of treatment, and prescribe opioids to reduce their patients’ suffering. But they should make the patients aware about the risk of addiction, teach them ways to properly store opioids at home and dispose when not required. Primary care physicians should also assess their patients of any underlying mental health problem and give equal weightage to emotional health. Prescription drug addiction is treatable with timely help.

The Florida Prescription Addiction Helpline can provide the required information to those in need and help them get connected to drug rehab centers in Florida that provide effective treatment options in a safe and secure environment. Call us at our helpline number (866) 292-3211 or chat with one of our medical representatives to know more about the best prescription drug abuse treatment centers in Florida.

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