In March of this year, the Centers for Disease Control and Prevention (CDC) released statistics about prescription opioid use in America and guidelines for their future use. They are strongly encouraging physicians and patients to explore safer alternatives, such as physical therapy.
WHAT ARE OPIOIDS?
Opioids are drugs which relieve moderate to severe pain. They produce a morphine-like effect by acting on opioid receptors. Opioids can be natural or synthetic. There are a wide variety of opioids, which range in usage and strength. Some examples of opioids include:
Given the diverse strengths of these opioids, they are used differently. Codeine, a weak opioid, is used to treat coughs. Hydrocodone is prescribed for things like dental pain or injuries. Morphine treats severe pain, like that experienced after surgery. Because opioids can act fast, they are often used to handle acute pain. Opioids are also common for those with terminal conditions like cancer or degenerative conditions like rheumatoid arthritis.
Side effects from opioids include euphoria, nausea, itchiness, sedation, constipation, and respiratory depression. Over time, patients will develop a tolerance for opioids. This means the dosage will need to be increased to see the same effects. Additionally, since opioids are addictive, there are withdrawal symptoms if patients suddenly discontinue use.
Since patients build a tolerance and become addicted to opioids, their risks outweigh the benefit for many non-cancer chronic conditions. Fibromyalgia, back pain, and headaches could be relieved by opioids but the downsides heavily outweigh the benefits. Patients experiencing non-malignant chronic pain should exhaust other safer options prior to relying on opioids.
STATISTICS ABOUT OPIOID PRESCRIPTION
The CDC’s numbers are startling. Since 1999, prescription opioid sales have quadrupled. This is not a case of the supply of medication meeting the demand from patients in pain. There is no evidence that people are experiencing chronic pain at a significantly higher rate.
Unfortunately, there is one correlation worth mentioning. The number of deaths related to prescription opioids has also quadrupled. Since 1999, over 165,000 Americans have died as a result of prescription opioid overdoses. More than 1,000 people end up in the emergency room every day as a result of misusing prescription opioids.
Healthcare providers wrote 259 million prescriptions for opioid pain medication. That number is hard to comprehend. Instead, consider that it is enough prescriptions for every American adult to get their own bottle of pills. Unsurprisingly, given the huge number of prescription opioids provided to patients with legitimate health concerns, around 60% of those prescribed opioids have leftover pills. Those who have extra pills may share them with others. Frighteningly, 1 in 5 people report sharing their medications.
People who are addicted to prescription opioids are 40 times more likely to become addicted to heroin. Sadly, between 2002 and 2014, the number of heroin-related deaths more than quadrupled.
It’s understandable why some patients prefer prescription opioids to physical therapy. Taking a pill seems like a much easier solution to pain. You can see and feel the results immediately, without having to struggle through physical activity. However, to see a long-term return to health, patients need to seriously consider physical therapy. Unlike opioids, which mask pain, physical therapy creates an actual, physical change. It takes longer and is significantly more work but, at the end, the cause of the pain can often be improved or eliminated.
A physical therapist assesses a patient’s condition and then helps build strength. This treats pain by rehabilitating damaged muscles or nerves and rebuilding atrophied muscles. A healthy, strong body is less likely to reinjure itself, since patients will be less prone to falls or unnecessarily stressing their joints. This is especially true for older individuals, who need to be strong to maintain their balance and prevent damaging falls. The weaker a senior is, the more likely they are to fall and the less prepared their body is to repair the damage.
PRESCRIPTION OPIOIDS VS PHYSICAL THERAPY
Despite all the serious dangers listed above, opioids can still absolutely help the healing process. No one is suggesting that surgery patients should go without relief! Acute pains, which last for a limited period of time, can be relieved very effectively with prescription medications. Additionally, patients with malignant cancer, whose time is sadly limited, can also be relieved from pain effectively with opioids.
Serious issues arise when long-term chronic pains are managed with opioids. Since our bodies get simultaneously addicted and tolerant to opioids, patients with legitimate health concerns end up escalating their drug activity in order to avoid withdrawal.
When you have a full life ahead of you, prescription opioids need to be a short term tool to facilitate a better, more long term plan. They can reduce your pain when you first start physical therapy, empowering you to build enough strength before getting off the drugs under your physician’s supervision. Patients should consider choosing physical therapy if:
- Pain lasts longer than 90 days
- Opioid use has more risks than rewards given their medical history
- Pain is related to low back pain, osteoarthritis, or fibromyalgia
- Patients want to fix their problems and return to health
Ultimately, opioids cannot be considered a solution to health problems. They are a tool that needs to be used cautiously as part of a larger plan. Don’t mask pain. Fix it! The South Texas Spinal Clinic has an experienced, dedicated team of licensed physical therapists who can help you return to health. Learn more about your treatment options today.