August 27, 2018
Opioid Crisis Illuminates the Need to See Pain Medicine Specialists
CHICAGO – The opioid crisis has made physicians increasingly wary about prescribing the potentially addictive drugs to their patients in pain. But there is a silver lining – experts in pain medicine, such as physician anesthesiologists, can create individualized pain management plans that include alternatives to opioids that are not only safer, but often work better.
“Opioids, or narcotics, can be helpful for short-term relief, but they are not a long-term solution for managing pain because of their many downsides, from significant side effects to a high risk of dependence or addiction,” said Greg L. Thompson, M.D., physician anesthesiologist, pain medicine specialist and member of the American Society of Anesthesiologists (ASA). “Pain medicine specialists can help people in pain get relief and reduce or eliminate opioids often by using a combination of techniques from physical therapy and nerve blocks to non-addictive pain medications.”
Opioids alleviated the excruciating pain 37-year-old mother of two, Beth Hunt, suffered while recovering from multiple surgeries after her leg was crushed in an accident. But after three months in the hospital on opioids, she came to rely on them just to be comfortable. Beth turned to Dr. Thompson who used ultrasound and tiny catheters, or tubes, to direct medication to the major nerves in her leg that were the source of the pain. This therapy reduced her opioid use by 90 percent while her leg healed and she learned to walk again. Now she is opioid-free, has regained her quality of life and is spending time being active with her children.
Beth never dreamed she’d become dependent on opioids, but her experience shows it can happen to anyone. During September’s Pain Awareness Month, ASA urges people to learn how the opioid crisis is changing the way physicians treat pain responsibly, and the many ways pain medicine specialists can help people get relief without opioids.
Safe and effective management of pain is the goal, which is why there are many good reasons your physician may limit or avoid prescribing opioids:
- They are not the only option: While opioids can provide general pain relief for a short while, they are not the solution for all pain because:
- There are more effective methods for treating pain in a specific site, such as a pinched nerve, slipped disc or traumatic injury, including nerve blocks or stimulation therapy.
- People who take them can begin tolerating the dose, and may need higher doses to get the same relief.
- There are many side effects and risks:
- Addiction and dependence are major worries. If there are signs of risk for addiction – such as being a smoker – your physician may be more hesitant to prescribe opioids. Long-term opioid use can lead to dependence and stopping them can cause withdrawal symptoms. Since this can be difficult to manage on your own, consult your physician anesthesiologist.
- Other side effects include: sleepiness; constipation; depression; life-threatening shallow breathing; and slowed heart rate, which could be a sign of an overdose.
- In older people, opioids can increase the risk of falling as well as interact with other medications, making them less effective or causing side effects. For example, opioids can interfere with sleep medication (commonly taken by older people), which can affect breathing.
- It’s the law: Legislators have enacted many rules and regulations in an attempt to stem the opioid crisis. For example, because studies show the longer people take opioids, the more likely they are to become addicted, some states have enacted prescribing limits on opioids. ASA supports patient-centered prescribing policies that consider individual patient needs, drawing on guidelines developed by medical specialty organizations. And prescription monitoring programs have been created in some states so physicians can see when a patient might be “doctor shopping,” or going from provider to provider asking for opioid prescriptions.
It’s important to know there are many other options for managing pain, from targeted therapies (e.g., nerve blocks) to non-addictive medications (e.g., antidepressants, antiseizure medications, acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen) to high-tech methods (e.g., spinal stimulation and radiowave therapy) to alternative treatments (e.g., physical therapy, acupuncture and meditation). Learn more about non-opioid options for managing pain.
“For some people, zero pain may not be possible,” said ASA President James D. Grant, M.D., M.B.A., FASA.“But with help, your pain can be managed. The pain medicine specialist is your partner and advocate on the journey to get your life back.”
Test your knowledge of opioids and pain management with ASA’s quiz. For more information about pain treatments and the importance of seeing a physician anesthesiologist, visit ASA’s pain management page.
The American Society of Anesthesiologists
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Like ASA on Facebook; follow ASALifeline on Twitter.
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