Jan 03rd 2018

Prevention of Opioid Abuse

For some of us, physical pain can seem a constant companion. Whether it's in the lower back or neck, joint pain is something that we learn to deal with, especially as we get older. Often we manage mild pain by popping some Advil, or taking a day off. But many of us will face life-inhibiting pain in the course of our lives that we cannot easily control.   In fact, lower-back pain is one of the leading causes behind scheduled doctor's appointments.

The education provided and choices shared during those visits with our doctors can make a difference in the care we receive as individual patients, as well as in the medical community's efforts to turn back the epidemic of opioid abuse in this country.

Some patients are prescribed opioids as an initial treatment for managing back pain. While that may seem to be an appropriate, convenient quick fix, opioids should be used only temporarily, and with a clear objective and goal. When these guidelines are not followed, it can lead to dangerous consequences. 

In some situations, dosed appropriately, prescription opioids are an appropriate part of medical treatment. 

But while people with chronic lower-back pain might receive some short-term relief with opioids, evidence has shown that opioid use to treat lower-back pain is simply masking the problem. That's the conclusion that was drawn from a JAMA Internal Medicine study on the efficacy, tolerability, and dose-dependent effect of opioid analgesics for lower-back pain. It found, after combining data from  20 high-quality randomized controlled trials, that while the drugs minimized the pain, the effects were not clinically significant and they did little to improve the patient's quality of life.

Conservative treatment such as physical therapy, chiropractic care, acupuncture, and yoga are all options that have been shown to be effective in treating back pain without taking on the risk of opioid use. It has also been proven that conservative treatments are generally more effective in the long term by improving the patient's mobility and quality of life.  Many studies show that manual therapies used by chiropractors and physical therapists are effective for the treatment of not only lower-back pain, but treatment of sciatica and neck pain, as well as many other conditions.

Similarly, conservative use of diagnostic imaging should also be considered. In fact, research has shown that patients who receive an MRI at the onset of their pain tend to experience higher costs and more aggressive treatment (such as injections and surgery) than patients who opt for more conservative treatment options, such as physical therapy.

Opioid Education

Providers and patients need to know the facts about opioids. If you are in acute pain and need medication for relief, a lot of doctors will prescribe them. But once you begin taking these drugs, it can lead you down a slippery slope.   Not only are opioids inherently addictive, but, over time, the body needs more and more opioids to feel the same effect. This raises your risk of addiction.

In addition, opioid risks include depression, overdose, and addiction, plus coping with the withdrawal symptoms when stopping use. In addition, people addicted to prescription opioids are 40 times more likely to become addicted to heroin.

Exploring alternative options that prior to prescribing opioids is an essential first step in managing the crisis. And research shows that it will likely lead to better, more long-term outcomes.

When considering treatment for your lower-back pain, it is essential to be educated on your treatment options.  The sooner you start physical therapy or chiropractic services, or return to activities such as walking, the faster you are likely to recover.

Visit eviCore.com/spinecorepath for more information on your path to recovery.