What Are The Alternatives to Opioids for Pain Relief?

Opioid addiction has been prominent in the news in recent years for reasons political, economic, and, for far too many Americans, personal.

With “pain” recorded as the most common reason we access the health care system—affecting more of us than heart disease, diabetes, and cancer combined—opioids for a while seemed like a natural solution to our problems. OxyContin, for example, was marketed for years as a non-addictive pain reliever, encouraging the drug’s spread beyond its traditional market of cancer patients. The result: a boom in sales and many billions of dollars in profit to Purdue Pharma. The problem: the drug was still addictive and subject to abuse.

According to the the American Society of Addiction Medicine, 259 million opioid prescriptions were written in 2012—enough to put a bottle of pills into the hands of every American adult. Keep in mind that four in five new heroin users start out with prescription opioids. And note that in 2015 there were 52,404 lethal drug overdoses in the United States, with nearly 13,000 of those deaths coming from heroin and more than 20,000 of the rest from prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl and others.

The statistics are depressing, but there remains a path to a solution if we step back and look at the original problem: pain. Opioids were and continue to be sold for their value as pain relievers, and there are plenty of cases where opioid therapy’s benefits outweigh the risks, including cancer pain, end-of-life pain, and acute pain. But market forces have lately pushed the use of opioids into areas where they really aren’t necessary, where there are safer, equally viable options available.

A randomized clinical trial published recently in the Journal of American Medicine proves the point. The study looked at 416 emergency room visitors in moderate to severe pain in their arms or legs from sprains, strains, fractures, or other injuries. The patients were given a randomized assignment of oral medications, including Tylenol, Advil, oxycodone, hydrocodone, or codeine. They reported their pain on an 11-point scale at the time of treatment and again two hours later.

The end result was a reduction in pain for all patients, but no statistical difference in pain relief between those who took opiates and those who took standard, less problematic, and less expensive over-the-counter treatments.

“Some docs will reflexively give an opioid to anyone with a fracture,” lead author Dr. Andrew K. Chang told the New York Times. “But if we can give the non-opioid and show the patient that it works, we can help with this ongoing opioid problem.”

And then there’s the type of pain and chronic pain that can be managed without drugs at all. For many conditions, Physical Therapy addresses the root cause of pain through treatments that include strengthening and flexibility exercises, manual therapy, posture awareness, and body mechanics instruction. It’s a much better approach than simply trying to cover it up through drugs that inhibit a person’s ability to feel pain.

The overprescription of opioids today is a big problem that will require multi-part solutions, with politicians, regulators, and doctors all getting involved. You can do your part by taking an active role in your own health and well-being, and seriously investigating the alternatives when it comes to what might seem at first like one harmless little pill.