Published 2nd February 2018, by ” The Conversation.com “
Opiods began being commonly prescribed in the 90s, despite limited research supporting their effectiveness for chronic pain that wasn’t caused by cancer.
Opioids are best used for acute pain management, to manage severe pain after surgery, injuries or burns, pain from problems such as kidney stones, gallbladder stones, pancreatitis and heart disease and in special situations like childbirth and end of life care.
Despite this, opioids became regularly prescribed for a wide range of pain conditions. This includes headaches, back pain, period pain, joint pain and chronic abdominal pain, despite little or no evidence they were effective.
Research has shown chronic use of opioids can make sufferers more sensitive to pain over time, an effect known as hyperalgesia. Recurrent short-term use for headaches in particular can lead to medication-overuse headaches that are worse and last longer.
It’s apparent 25 years on that the long term use of opioids has resulted in a wider range of harms than was expected. Problems include chronic nausea and constipation, hormone suppression causing low libido, osteoporosis and dental problems, immune suppression increasing the risk of infections, cognitive impairment and sleep disordered breathing that can lead to death. And this is not to mention the significant dependence and addiction problems.
Pain management approaches, if skilfully applied, are much safer and more effective for most people. These include non-drug strategies such as physiotherapy or exercise physiology, mind-body relaxation techniques such as breathing techniques and mindfulness meditation, hypnosis and other behaviour therapies. As well as lifestyle changes such as stretching, walking and pacing activity, diet and nutrition changes, improving sleep hygiene and addressing relationship problems. These should be first line treatments.
If these fail, non-opioid analgesics (such as paracetamol, anti-inflammatories, topical treatments, anticonvulsants and antidepressants) or medications specific for the condition (such as tryptans for migraine, disease-modifying drugs for rheumatoid arthritis and other autoimmune diseases) are safer and may be more effective in treating chronic pain. This is because they work through the many other, complex mechanisms and brain pathways involved in persistent pain.
Few specialists, long waiting times and challenging travel arrangements to attend pain management clinics mean many chronic pain sufferers can’t easily access the most effective care. They have to rely on their time-poor GP for whom writing a prescription for an opioid is quick and easy. Arranging referrals to several allied health professionals as part of a co-ordinated plan is too difficult for many.
Opioid misuse in Australia is a complex societal problem. It can’t be blamed on any one group of medical practitioners, regulators or patients. Options for tightening up federal rules are under consideration.
REF: Cragie, M. (2018). Fixing pain management could help us solve the opioid crisis. [online] The Conversation. Available at: https://theconversation.com/fixing-pain-management-could-help-us-solve-the-opioid-crisis-90919 [Accessed 5 Feb. 2018].
TAGS: Macquarie Stem Cells, Dr. Ralph Bright,Stem Cell Therapy, Stem Cells, Keeping away from Pain Medication, Opioid Crisis