No one wants to rely on drugs to get through the day, but chronic pain can be a daunting challenge.
As a nurse practitioner who specializes in the treatment of chronic pain, I am often asked by patients if it would be beneficial to get off pain medications. As with any medical treatment, we in the medical profession strive to do the most good with the least possible intervention.
Opioids, more commonly known as narcotics, include drugs like morphine, oxycodone, fentanyl, methadone and others. These drugs are very powerful and should only be used under certain circumstances and with great care. Medical professionals like to limit their use to short-term, acute pain episodes than can follow injury or surgery, or to end-of-life treatment of pain for those with a diagnosed terminal illness.
No medication is risk-free, but opioids are a particularly scary class of medications for a number of reasons. If they are used long term for chronic conditions, there is a 40-percent chance of addiction. One can become dependent on them in a very short time.
Using them can contribute to falls, particularly in vulnerable elderly patients. They can also impair one’s ability to drive and can limit freedom. Their constipating effects can often lead to bowel complications. They can be particularly dangerous when used along with alcohol and other drugs.
If absolutely needed, these drugs should be used for the shortest possible time at the lowest possible dose. Eventually the risks will begin to outweigh any benefits. This is the time when such drugs should be tapered and stopped, and alternative treatments should be sought, in consultation with one’s health care provider.
A wide range of options is available to provide pain relief without the dangers of narcotics. Exercise can help some folks get through chronic pain, beginning with physical therapy. This kind of treatment is certainly not effective overnight, but studies have shown that following such an exercise program faithfully for eight weeks can eventually help some people cope with their pain. And exercise can be habit-forming — in a good way!
Additional treatments that have been shown to help with chronic pain include acupuncture, injections, osteopathic manipulation and therapeutic massage. NSAIDS, such as aspirin and ibuprofen (Advil, Motrin) work for some, as well as acetaminophen (Tylenol). Some antidepressants and anti seizure medications offer pain killing qualities for some, and they are much less dangerous than narcotics.
Remember, no single pain treatment is appropriate for every person. If you are suffering from chronic pain, please work with your health care provider and team to treat your pain in the safest way that works for you. Communication and patience will help keep you feeling your best.
Eva Quirion is a family nurse practitioner with St. Joseph Internal Medicine.