Alternatives to Pain Medication
In a recent article featured on the website of The Partnership at DrugFree.org, Dr. Timothy Deer discussed why he has changed his ideas about the role of the physician in pain intervention. A medical doctor who runs The Center for Pain Relief in West Virginia, he says it’s too easy to reach for opioids, or narcotic analgesics like Percocet and Vicodin, as the first line of treatment for people suffering discomfort from illness or trauma.
Like most physicians, he routinely prescribes opioids when he’s treating cancer patients, he says, but then that mindset carries over to other patients as well. Pretty soon the doctor is prescribing opioids without giving much thought to other options. He realized he had to help his patients suffering from pain killer addiction by focusing on other ways to their treat chronic pain.
There are multiple pitfalls associated with opioid treatment, according to Dr. Deer.
- People soon develop a tolerance for the pain medication. Tolerance means the person becomes accustomed to the medication, and it no longer works well for him, requiring larger doses. For some it’s sooner rather than later; the length of time until tolerance becomes an issue depends on the individual patient.
- Addiction occurs, which means the person wants the medication whether he needs it to treat his pain or not. The recent fifth edition of the DSM, the Diagnostic and Statistical Manual used by psychiatrists, discusses substance use disorders in terms of tolerance and dependence rather than addiction or abuse, but the fact remains that when someone begins to feel sick if he does not take that medication, then he has a problem.
- Accidental overdose of the person who is misusing his medication can go way past drug-related illness and cause death.
- Diversion is another problem, which occurs when the patient gives or sells his medication to other people. It doesn’t matter whether he does it to make money or to enable someone close to him who is using drugs; it sidesteps the original purpose of the prescription.
For the person with a pain killer addiction, simply stopping the medication leaves him with pain issues that are still unresolved. Dr. Deer has been recommending the following treatment modalities for the person who is struggling with addiction and pain:
- Fluoroscopic-Guided Interventional Nerve Blocks. Nerve blocks typically mean that an injection of medication interrupts the signal that travels from the site of pain to the brain. Today’s technology allows a physician much greater accuracy in getting the injection to the precise spot through the use of radiography equipment to direct the needle.
- Radiofrequency Ablation. If a nerve block successfully stops pain, the doctor knows he has reached the right area. He can then utilize radio waves to generate heat that will destroy nerve tissue, and the patient can gain relief from pain that possibly lasts up to 18 months. If the nerves are outside of the spinal column, the procedure may be too dangerous, and so pulsed radiofrequency using lower levels of heat applied in bursts can help.
- Spinal Cord Stimulation. In this kind of treatment, the doctor inserts an electrical device into the back, much like a pacemaker, that sends electrical pulses to the site of the pain.
These are just a few of the new treatment options for the person who is suffering from pain medication addiction as well as chronic pain. Some of the older ways of managing pain are also still successful, such as non-steroidal anti-inflammatory medications instead of narcotic analgesics, or physical therapy treatments. But it takes a team of people to treat the patient—a substance abuse professional who can help the person learn how to manage his addiction as well as a physician who takes the patient’s complaints of pain seriously. If you need help finding the right professionals, call your local drug rehab center today.
You can read more about Dr. Deer’s work at http://www.drugfree.org/join-together/healthcare/the-quest-for-alternatives-to-opioids-in-chronic-pain-the-role-of-the-interventional-pain-physician.