Is it Worth Taking Opioids for Pain Relief?9 months ago | Prescription Drugs
By Joy Stephenson-Laws, J.D.,Founder
As human beings, it is difficult to be patient when we have acute or chronic pain. It is a sensation we desperately try to avoid, and if it hits we do what we can to limit the experience. Julius Caesar said, “[i]t is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.”
And as well as music relaxes me, I totally disagree with Bob Marley that “[o]ne good thing about music, when it hits, you feel no pain.”
Doctors also agree we need more for pain besides music. When they anticipate we might have pain, like during or after surgery, they will take action to prevent us from having pain by prescribing medication to reduce or eliminate the pain. But sometimes, they go too far. They may unwittingly prescribe pain medications that turn us into addicts or even kill us!
Recently, I had dental surgery. In anticipation of my discomfort and pain after the surgery, my very considerate dentist prescribed seven days’ worth of ibuprofen and hydrocodone. After researching these two pain medications, I decided to take the ibuprofen, which was very effective after taking them for only two days. Thankfully, I didn’t need any of the 21 hydrocodone pills.
So what did I learn about hydrocodone?
Hydrocodone is a prescription opioid that could make me vulnerable to becoming an addict. According to new research, opioids like hydrocodone should be prescribed for the “shortest duration possible” (in non-cancer patients), because the likelihood of abuse or chronic use increases after the third day of taking the drug and rises “rapidly thereafter.” Prescribing less than seven days’ worth (ideally three days’ worth or less) could reduce my chances of unintentional long-term use, they say.
What are opioids?
Opioids are a type of prescription drug that doctors prescribe for acute or chronic pain. Some of the more common ones include methadone, oxycodone (such as OxyContin®), hydrocodone (such as Vicodin®) and morphine.
Fentanyl is a synthetic opioid that is significantly more powerful than other types of opioids. If it sounds familiar, you may recall iconic singer Prince died of an accidental fentanyl overdose, according to his autopsy. This drug is approved for severe pain relief, such as for patients with advanced cancer, the Centers for Disease Control and Prevention says. It is about 50 to 100 times stronger than morphine.
What are the risks of opioids?
The risks of opioids are not to be taken lightly, as they can include addiction and unintentional overdose -- even death. From 1999 to 2015, more than 183,000 people died in the United States from prescription opioid-related overdoses, the CDC says.
Even when taking these pain relievers as directed, there is still the potential for side effects. These may include:
- Developing a tolerance (you need to take more of the medication for the same amount of relief)
- Developing a physical dependence (you have withdrawal symptoms when stopping the opioid)
- Increased sensitivity to pain
- Nausea, vomiting and dry mouth
- Sleepiness and dizziness
- Low testosterone levels (can cause lower sex drive, energy and strength)
What can you do to be proactive if you have been prescribed opioids?
A recent study sheds light on the importance of talking to your doctor early on about the duration of your opioid use to prevent long-term use and, ultimately, addiction.
Among cancer-free patients who were prescribed at least one day of opioids, there was a 6 percent chance they’d still be taking opioids one year later. The longer they were taking opioids, the more likely they would continue using them for at least a year (or for multiple years!).
Believe it or not, the risk for long-term opioid use jumped sharply after mere days of opioid use (particularly after only five days!). (See chart). Furthermore, approximately 1 in 7 people who received a refill or a second opioid prescription were on opioids one year later, highlighting the importance of checking in with your doctor before that refill!
Make sure you are using your prescription safely to manage pain. You should only use opioids if you really need them, and never share your opioids.
The CDC recommends that you avoid taking the following with opioids:
- Benzodiazepines (such as Xanax and Valium) unless advised by a knowledgeable doctor
- Muscle relaxants (such as Soma or Flexeril) unless advised by a knowledgeable doctor
- Hypnotics (such as Ambien or Lunesta) unless advised by a knowledgeable doctor
- Other prescription opioid pain relievers
Don’t be shy about asking your doctor questions to ensure you understand the dosage, how to take your medication, what the side effects may be and why you are being prescribed the medication. Address any concerns you have, including whether there are non-opioid options you can try. You may have options that are not only more effective for you, but that come with fewer risks and side effects.
According to the CDC, alternatives to opioids may include acetaminophen (Tylenol), ibuprofen (Advil), cognitive behavioral therapy, physical therapy and exercise, medications for depression and seizures and interventional therapies (injections).
Use minerals to help!
You should also discuss minerals with your doctor! You may be surprised to learn minerals can be quite beneficial for managing pain.
Magnesium actually has anti-nociceptor effects, meaning it can keep the nociceptor (a sensory receptor for pain) from overreacting when it talks to your brain about the pain you are experiencing. In a study of hip replacement patients, magnesium plus morphine was more effective than morphine used alone for pain.
Another mineral to keep in mind is zinc. Animal studies suggest it may even help with opioid withdrawal and addiction. In fact, pharmacologists who wrote an article on zinc and pain are calling for it to be a supplement that goes with every prescription of Percocet, Vicodin and Norco! You can read more about minerals and pain in Minerals - The Forgotten Nutrient: Your Secret Weapon for Getting and Staying Healthy.
Final word of advice: Don’t keep the leftovers
In order to safely dispose of unused opioids, look into your local drug take-back program or your pharmacy’s mail-back program.
Enjoy Your Healthy Life!
The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. To learn more about the pH Health Care Team, click here.