Navigating Pain Relief With and Without Opioids

Pain is a cruel master. When it strikes, there is nothing beyond it. No life, no relationships, no you. There are only the pain and the need to get it to stop, no matter what.

According to recent estimates from the CDC, 1 in 5 Americans is currently living with chronic pain. That’s about 50 million people in the United States alone. And of those 50 million, nearly half reported experiencing chronic pain so intense it interfered with their daily functioning.

Once upon a time, the standard protocol was to treat chronic pain sufferers with opioids. But, unless you’ve been living under a rock, you’ve probably read and seen more horrific reports of the ravages of the opioid epidemic than you care to recall. On an average day in America, more than 130 lives are lost to opioid addiction.

The result has been a significant crackdown, led by the US federal government, on the dispensing of opioids for all but the most severe, short-term pain. But what of the tens of millions of people in the US whose pain simply isn’t going to go away, whether due to the lingering effects of traumatic injury or the ravages of chronic disease?

How can we best navigate pain relief, both with and without opioids? How can we relieve the suffering of those who have chronic pain, without falling prey to opioid addiction?

A Public Health Emergency?

There can be no question that the old way of using opioids was not only ineffective, it was downright dangerous. For far too long, doctors were dispensing prescription narcotics like Halloween candy, with little understanding or recognition of the mechanisms of addiction.

This has created not only a crisis for individual and family health, but for public health as well. In addition to the scores of precious lives being cut short, often in their prime, every day in America, opioid addiction is also taking a devastating toll on entire communities. Not only is opioid addiction limiting people’s ability to work, but it’s also impacting some people’s ability to maintain stable housing. As the severity of the addiction grows, relationships suffer, and addicts may easily find themselves on the streets, without friends or family to turn to.

Without access to housing, adequate medical care, and social or familial support, addicts are at increased risk of physical and mental illness, including the risk of acquiring, and spreading, communicable diseases, from hepatitis and tuberculosis to HIV. The National Institutes of Health estimated that, in 2013 alone, the opioid epidemic cost the national economy nearly $80 billion. That’s billion with a b.

It’s little wonder, then, that the opioid epidemic is currently being treated as a public health emergency. To save lives and relieve the tremendous financial burden of opioid addiction, the federal government has instituted sweeping reforms to limit access to opioid pain relievers.

The Responsible Use of Opioids?

In the face of a national opioid epidemic, is there still a place for narcotics for the relief of severe, otherwise largely uncontrollable, pain? The short answer is yes.

For specific people, in specific circumstances, and under specific conditions, opioid pain relief is more than an option. It’s a necessity. When a patient is experiencing extreme, intractable, and rebound pain, to deny treatment with opioids may well be both cruel and dangerous.

At the same time, however, prescribing opioids without a clear, careful, and precise plan in place to mitigate the risk of addiction is equally inhumane and reckless. Responsible, ethical patient care demands that prescribes assess patients’ addiction risk and weigh those risks against the risks of opioid treatment.

Responsible use demands, for example, the prescribing of the lowest effective treatment dosages for the shortest possible duration. It also requires a protocol for weaning patients off the medication while substituting viable alternatives.

Additionally, it means ongoing patient monitoring during this weaning process. Incipient signs of addiction should be addressed immediately and aggressively, whether through in-patient or outpatient addiction intervention, ranging from medical detox to psychotherapy.

Pain Relief Alternatives

It’s naive and perhaps even cruel simply to abandon the use of opiates entirely. In some cases, opiates may be the only effective option for treating the most severe pain, like when a person is recovering from surgery or battling advanced-stage cancer. In these circumstances, narcotics may be only option strong enough to provide any measure of relief.

When circumstances aren’t quite so extreme, or when a diagnosis is non-terminal but chronic, then turning to opioids is likely not the best long-term solution. But giving up the opioids doesn’t mean giving up the hope for a life free of severe pain. You can still manage your pain and enjoy the quality of life you deserve without the narcotics.

As support for the legalization of marijuana continues to grow nationwide, researchers are increasingly seeking to understand the medicinal properties of marijuana and its components. CBD, in particular, has been linked to numerous health benefits, from reducing inflammation to relieving neuropathies. Best of all, unlike THC, the other major chemical found in marijuana, CBD doesn’t produce psychotropic effects.

Not only will you not get “high” from CBD or risk becoming addicted to it, but it has also proven effective in combating addiction. CBD is increasingly being used, in fact, to treat opioid withdrawal symptoms. This includes the use of CBD not only to manage the physical symptoms of withdrawal but also to fight the stress and anxiety that accompany opioid detox.

When it comes to using CBD products for pain relief or the treatment of opioid withdrawal symptoms, however, it’s essential to know which CBD-based products are best for your particular needs. “Full-spectrum” CBD, for example, includes terpenes, which are plant materials harvested along with the cannabis plant. These terpenes are said to enhance the effects of CBD, particularly its calming properties.

Exercise and Meditation

In addition to short-term opioid use or the incorporation of CBD products, there are also a number of lifestyle changes you can make if you are experiencing chronic pain. Daily meditation is a powerful way to relieve stress, and stress is notorious for worsening pain.

Likewise, gentle exercise, such as yoga or pilates, will not only relieve stress but will also increase flexibility and muscle strength. Your balance and coordination will improve, decreasing the risk of dangerous falls, and your joints, bones, and muscles will have more stability. The result: less musculoskeletal and neuropathic pain.

The Takeaway

For far too many of us, pain is a fact of daily life and the origin of today’s deadly opioid epidemic. However, chronic pain doesn’t have to rob you of your joy. It doesn’t have to steal your life. There are options for managing chronic pain, both with and without opioids. All that’s required is a little bit of knowledge and a lot of hope and perseverance.