What a Pain!

By Steve Baldridge

Here are a few sobering statistics for you:

About 5,000 people die from opioid overdoses in Ohio each year.

Currently 70% of the children in Ohio child welfare programs have opioid-involved parents.
In Ohio, 35% of all charges against women in the last decade were drug related. This statistic doesn't include theft and burglary, which are often tied to addiction.

There are many aspects to this crisis, and too many to go into here, so today, we will look at the opioids themselves from a medical standpoint.  We will also consider some alternatives that are available, allowing us to depend on these potent pharmaceuticals less heavily.

 Opioids, often called narcotics, are a type of drug. The term “narcotic” comes from the Greek word for “stupor” and originally referred to a variety of substances that dulled the senses and relieved pain. Opioids include strong prescription pain relievers, such as morphine, codeine, oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. These chemical compounds were originally found in opium. Today, many drugs in the opioid category don't actually come from opium.

 Used correctly, these substances offer great relief. They can be used to reduce pain from a major injury or surgery, and a can provide immense  benefit for those in severe pain from health conditions like cancer. Opioids diminish the intensity of pain signals through our nervous system and are generally prescribed for the treatment of pain. However, we are learning at great cost that these are not always the best choice, especially for chronic pain. People who take opioids are at risk for opioid dependence, addiction, and overdose. Why is there such a huge risk for abuse of opioids? Opioids have the additional effect of causing a sense of euphoria. It feels good! Everything feels good! Think what a tempting trap this is. From misery, pain, and even the accompanying depression, to euphoria – no misery, no pain, no depression - in moments. Sure, when the drug wears off, the misery returns, but while it lasts – bliss. And do you remember what narcotic means? Stupor. In this stuporous condition, it is easy for someone to misjudge a dose, and in an attempt to   put off the inevitable return of the pain and misery, to accidentally overdose.

 So, what can we do? First, we must start at the beginning and define pain. The International Association for the Study of Pain provides the most frequently used definition of pain: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

Pain can be acute (short term), or chronic (long term). Pain can be steady or intermittent, throbbing, stabbing, aching, pinching, or described in many other ways. Sometimes, it’s just a nuisance, like a mild headache. Other times it can be absolutely debilitating.

One of the most frustrating things about pain is that pain itself cannot be seen on any medical test or imaging study. In fact, there is no way to tell how much someone is hurting based upon the x-ray, CT scan, or MRI. A person can have absolutely no abnormalities on an MRI and still experience severe pain while another person can have several bulging discs (for example) and experience no pains whatsoever. Pain can bring about other physical symptoms, like nausea, dizziness, weakness or drowsiness. It can cause emotional effects like anger, depression, mood swings or irritability. Perhaps most significantly, it can change your lifestyle and impact your job, relationships and independence. Pain tells you something may be wrong. But once you know something is wrong, what do you do? Deal with it or resort to opioids? Let’s explore other options.

 What other options do we have? It really depends on the causes of an individual’s pain, but could include:

  • Injection therapies, such as epidural steroid injection, facet joint injection, selective nerve root block, and radiofrequency ablation (RFA).
  • Physical and occupational therapy.
  • Exercise to prevent further problems and reduce spasticity, joint contractures, joint inflammation, spinal alignment problems, or muscle weakening and shrinking.
  • Emotional and psychological support, which may include: stress management, relaxation training, and music therapy, just to name a few.

 Opioids are a blessing and a curse. Overcoming the curse is a bigger problem than one single approach can resolve, but let’s start somewhere. Learn about one way University Hospitals is attacking the curse by offering alternatives to opioids where appropriate. Join us Thursday, September 26, 2019 as Sara Baldosser, Regional Director of Operations with Pain Management Group and Samaritan Pain Management, presents “Making An Impact On The Opioid Crisis Through Accountable Pain Management”. We will meet at 5:30 p.m. in the UH Administrative Services Building, 663 East Main Street, Ashland, OH

Register for this FREE program by calling 419-207-2563.

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