opioid use and abuse

Learn why car accident victims are at high risk for opioid abuse, and how to avoid falling victim to addiction.

Pain is a common after-effect of motor vehicle accidents, and many accident victims are given prescription pain medications. Unfortunately, the urgency of patient needs, the effectiveness of opioid pain medications, and limited treatment options for those suffering from chronic pain have led to an overreliance on pain medications in the United States — the opioid epidemic.

The American Academy of Pain Medicine recommends that opioid pain medications be used only for chronic, persistent pain that cannot be controlled through conservative pain management. Yet, according to a 2016 article in Pain Medicine, auto accident victims are very likely to receive prescription opioids for their pain, and are also extremely likely to abuse these medications.

According to the article, the two main reasons for this high risk of abuse are:

  • Potential mental trauma. Traumatic injuries often are associated with mental health disorders such as post-traumatic stress disorder (PTSD) and depression, which are major risk factors for opioid abuse. Anxiety medications known as benzodiazepines (Xanax, Valium, Klonopin, and others) are not recommended for post-traumatic stress disorder but are still commonly prescribed for injury patients, increasing the risk of unfavorable outcomes.
  • Absence of a Primary Physician. Motor vehicle crash injuries are typically treated by a number of different medical practitioners, including emergency department physicians, physical therapists, orthopedic surgeons, and general practitioners, with no one health care professional taking primary responsibility for the opioids prescribed to the accident victim. Because of the potential for oversight, car accident victims are generally at higher risk for prolonged opioid use and adverse outcomes than a typical patient.

Despite their widespread use, opioids have been found to be no more effective in controlling chronic pain than nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

Dependency Versus Addiction

Another study published in the journal Pain concluded that persistent pain reported by injured individuals six weeks after an automobile accident was not statistically different between those prescribed NSAIDs and those given opioids such as oxycodone. But one key difference was found: Those initially prescribed opioids were 17.6 percent more likely to be dependent on them six weeks later.

According to the Pain study, the repeated administration of any opioid almost always results in tolerance and physical dependence, but the short-term results will usually resolve in a few days or weeks after discontinuation of the opioid, depending on the type of medication and the dose.

However, when opioids are prescribed long-term, their analgesic effects can require increasingly higher doses. While addiction only occurs in a relatively small percentage of patients, once it develops it becomes a separate medical illness that will usually not be resolved simply by discontinuation of the drug. Without proper treatment, this addiction can carry a high risk of relapse for years to come.

Avoiding Opioid Abuse

Talking to your doctor about alternative pain management treatments will help you avoid opioid abuse. But if opioids are unavoidable despite your risk level for addiction — family history, previous issues with drug use, or mental illness — following some precautions can stop a potential long-term problem before it takes root.

  • Use medication only as prescribed. Opioids should only ever be used under the supervision of a physician. If you’ve been taking pain medication for longer than two weeks, it is not safe to abruptly discontinue usage. Speak with your doctor about ways you can safely taper off based on the particular drug and dosage you are using.
  • Anticipate withdrawal. Understand potential symptoms of opioid withdrawal and what to expect. Depending on the drug, dosage, and length of time you were taking the drug, withdrawal symptoms can last up to five days. Some chronic symptoms may persist for longer, such as anxiety or insomnia. Work to minimize the negative effects by gradually reducing your dosage based on your physician’s recommendations.
  • Seek support early. Let friends or family members know about your plans to manage opioid withdrawal following your injury. It can be dangerous to go through withdrawal on your own. Seek support through addiction support groups or an appropriate psychological specialist.
  • Create a plan. With the help of an addiction specialist, be as prepared as possible and follow your withdrawal plan closely. Having such a recovery plan can help you establish goals and see them through.

Alternative Methods for Managing Pain

Learn alternative methods for managing pain that may help ease withdrawal symptoms and avoid relapsing, such as regular exercise, physical therapy, mindfulness, and massage.

While your pain may cause you to want to avoid excessive movement, stretching, strengthening, and cardiovascular exercises can actually help you find relief. It’s advisable to start slowly, stretch thoroughly after any activity, and modify any exercise that might aggravate your particular condition.

In conjunction with exercise, physical therapy can be particularly effective in treating, preventing, and managing pain following an auto accident or other injury. Therapists can help you increase your range of motion and level of flexibility while teaching you how to perform everyday tasks in a way that places less stress on the body. In fact, the CDC recommends alternative treatments like physical therapy because opioids only mask pain rather than improving your physical condition.

Mindfulness meditation has also been proven effective at reducing pain and offers a legitimate alternative for those seeking to avoid pain medications. The practice of focusing on the present moment can be helpful, even if only used a few minutes per day. Focused breathing and calming of the body might sound too easy, but studies indicate mindfulness can be as effective as pain-relieving medicines, without the harmful side effects.

While research is more limited in areas like acupuncture, massage, and tai chi, some find these alternative treatments helpful in avoiding opioids. Talk to your doctor about which option might work best for you, and remember, there are many noninvasive, safe, yet effective treatment options to help you overcome addiction.

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