Opioid medications can be used to treat pain. Their abundant use for both acute and chronic pain has led to an epidemic in the United States, which more recently has become publicized. It’s imperative to know what opioid medications are and how to use them safely.
What are Opioid Medications?
Common prescription opioid medications include:
Hydrocodone (Norco and Vicodin)
Oxycodone (Oxycontin and Percocet)
Common nonprescription opioids are:
Are Opioid Medications Safe?
Opioid medications are natural and synthetic chemicals that can reduce pain, but they also have side effects such as euphoria which can very easily lead to addiction and abuse. Use of these medications short-term for pain control can be beneficial, especially in the setting of recent surgery. However, it’s easy and dangerous to continue to using them once the pain improves due to the euphoric feeling and tolerance to the medications. Even after one initial dose of an opioid, your body becomes used to the medication, and you require more to achieve the same effect, which is called tolerance. In its worst form, tolerance leads to increased sensitivity to pain. Additionally, it’s easy to start using the medications just to feel better, improve depressive symptoms or sleep. When patients start using the opioid medications for symptoms other than pain control, even unintentionally, they become extremely dangerous and harmful.
Opioid medications have numerous side effects which can be harmful. These include constipation, increased sensitivity to pain, nausea and vomiting, sleepiness, confusion, depression, lower sex drive, itching and sweating.
What is the Best Way to Use an Opioid?
It is best to use opioids in the least amount possible. It’s recommended to try any other form of pain control first and quickly switch to these other forms as soon as possible after an opioid is started. Opioids should only be used in the acute setting after surgery, and an immediate plan to wean from the opioids should be constructed. Chronic opioid use should rarely be considered, with the exception of active cancer treatment, palliative or end of life care.
If you are prescribed opioids, only take them as directed and never in greater amounts than prescribed. Avoid using with alcohol, benzodiazepines or sleep medications. Never share these medications with friends or family, even if they happen to be on the same medication or amount. If you still have pills after you no longer need them, safely dispose of unused pills by bringing them back to your pharmacy. You cannot simply throw them away in the trash or flush them down the toilet. Never store extra pain medications thinking you can take them for another indication in the future.
What are Some Alternatives to Opioids?
Acetaminophen (Tylenol): This is a good pain reliever. Excessive use can affect the liver. Do not take Tylenol in addition to Norco, Vicodin or Percocet as these medications also contain Tylenol. As this medication does not have any anti-inflammatory effect, it can be taken following fusion spine procedures.
Nonsteroidal anti-inflammatories (NSAIDs, such as Ibuprofen, Advil, Aleve, Mobic, Aspirin): These are also good pain reliever and anti-inflammatory options. Excessive use can affect the stomach and kidneys. This medication should not be taken following spine fusion procedures unless your surgeon has approved the usage.
Other alternatives include the following:
Cognitive behavior therapy.
Physical therapy and exercise
Oral steroids and injections.
Nerve medications such as Gabapentin (Neurontin) and Lyrica.
Why is My Physician Hesitant to Prescribe Opioids?
As more information about opioids is being discovered, both patient and physicians are learning more. Unfortunately, most physicians previously thought opioids were safe. It’s now abundantly clear that they are not. The Centers for Disease Control (CDC) is now forming new recommendations for prescribing opiates, which includes routine urine screening and pain contracts with patients. As most physicians, including surgeons, do not have the ability to test their patient’s urine and closely monitor use, opioid management may best be managed by specially trained pain physicians. Sometimes, primary care providers are willing to provide this service, but most surgeons are logistically unable. Again, physicians do not assume all of their patients are “drug addicts” or wish for their patients to “suffer” without medication. And even very intelligent and careful patients can accidentally misuse these medications.
At Rocky Mountain Brain & Spine Institute, we care about your health and well-being. If you, or a loved one, are suffering from opioid abuse, we insist you seek help. Contact us today with any questions on how we can help.