Chronic pain is one of the leading health issues in the nation, as it affects the quality of life of more than 100 million Americans — more than heart disease, cancer and diabetes combined.1 To combat this issue, more than 200 million opioid prescriptions are written in the US each year, according to the Centers for Disease Control and Prevention.2 Of those who are prescribed opioids, 10 to 15 percent develop addictions to the drugs, and millions more misuse them recreationally without chronic pain. This mass dispensing and abuse kills nearly 40 people each day.1
Because there is such a high risk of opioid addiction and its life-altering consequences, it’s important to consider alternative treatments when determining if opioids are the right solution for your pain management.
Understanding Pain Management and Recognizing Alternatives
Opioids are typically prescribed to treat acute pain immediately following a trauma or physical injury, but people can also take them to manage chronic pain from diseases like fibromyalgia, rheumatoid arthritis and Lyme disease.2 Opioids may also be given to patients during painful procedures to decrease pain.
While opioids have been the drug of choice for most of these conditions over the years, there are alternatives that offer the same level of treatment, while posing far fewer long-term addictive risks.
From medications and habits to therapies and programs, there are many alternatives you can evaluate against opioids when determining the right pain management solution.
In a study published by the Journal of the American Medical Association, researchers studied 416 patients, who had moderate to severe pain, and gave them doses of acetaminophen (Tylenol) with either ibuprofen (Advil) or the opioids oxycodone, hydrocodone or codeine. They then asked the patients to rate their pain on an 11-point scale, and found there was no significant difference between those who took opioids and those who took non-opioids.3
These results point to the effectiveness of standard over-the-counter medications for alleviating pain; if you can treat your condition with the Advil or Tylenol in your medicine cabinet, it may be worth it to go that route. Just note that there are risks of stomach disease with nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil, and risks of liver damage with acetaminophen (found in Tylenol) if taken on a long-term, regular basis.2
Therapies and healthy habits
Medication is not the only way to deal with pain. Especially for chronic conditions, non-drug treatments like exercise, physical therapy, yoga, acupuncture, chiropractic and relaxation training, cognitive behavioral therapy and biofeedback can be effective. These treatments pose the smallest risk, and are the first course of action recommended by the American College of Physicians, the US Department of Veterans Affairs and the CDC. 2
Virtual reality and hypnosis
Distraction is extremely effective for reducing pain intensity. If you’re focused on something else, you may not realize how severe your pain is. That’s why Harborview Medical Center in Seattle has started to use immersive virtual reality (VR) during painful medical procedures. Patients become so engrossed in the VR game that they are less aware of the pain. In fact, one study found that pain was reduced by 30 to 50 percent when VR interventions were administered.4
Hypnosis is another model of VR being used to distract patients from painful procedures. One of the creators of the VR program SnowWorld also attempted to use hypnosis on a burn patient during a wound care session, and saw pain-free results. The patient compared the approach to meditation and has been able to use hypnosis as a way to cut back on opioids.4
Pain management programs
A pain management program that covers opioid education as a well as alternative treatments can provide patients with the comprehensive care they need. Kaiser Permanente currently offers Integrated Pain Service, an eight-week course for high-risk opioid patients that includes access to professional medical care, teachings on the science behind prescription drugs and alternative treatments such as exercise, acupuncture and meditation.5
Kaiser tracked 80 patients in the program over a year and found their emergency room visits decreased by 25 percent and their inpatient admissions decreased by 40 percent.5 While hard to replicate on a national scale, the Kaiser program serves as a successful model for integrated pain management.
All About the Right Alternative
Just like opioids, not all of these alternative treatments are right for everyone. It all depends on the person, and the level and type of pain he or she experiences. Be sure to talk to a trusted physician about what pain treatment is the best fit for you. With professional guidance and research, you’ll find the right alternative.
1 Hauser, Annie. “Opioid-Free Ways to Live Well With Chronic Pain.” Everyday Health, August 29, 2012.
2 Beaugureau, Marie. “6 Alternatives to Opioids for Pain.” GoodRx, November 16, 2017.
3 Bakalar, Nicholas. “Alternatives to Opioids for Pain Relief.” The New York Times, November 8, 2017.
4 Hellerman, Caleb. “Finding Alternatives to Opioids.” Nova Next, August 31, 2017.
5 Daley, John. “Pain Management Program Offers an Alternative to Opioids.” NPR, December 29, 2017.
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.