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Chronic pain is an ongoing and persistent pain that can become quite debilitating for those who live with it. People who suffer from chronic pain are often eager to find relief. In most cases, doctors will prescribe opioids as a treatment for patients with chronic pain. While this type of treatment can work for many, in some cases, it can be the onset of an opioid use disorder, which can create more significant problems for the patient.
The use of opioids as a treatment plan for chronic pain can come at a very high risk for some. If you or someone you love struggles with chronic pain, it is essential to gain a comprehensive understanding of chronic pain and its different treatment methods. You should know what chronic pain is, how opioids work as a treatment for chronic pain, the threat and symptoms of addiction to opioids, alternative treatment plans for chronic pain, and treatment for opioid use disorders.
Acute pain is a normal sensation in the nervous system that alerts the body of a possible injury and the necessity of care. Chronic pain is different from acute pain in that it is ongoing and persistent. Someone with chronic pain will experience pain signals firing in their nervous system for weeks, months, and even many years. An initial mishap may cause chronic pain, or there may be an ongoing cause of pain. 1
Chronic pain usually lasts longer than six months and is often accompanied by anger, depression, anxiety, low sex drive, and disability.2 Chronic pain can be quite debilitating and may prevent someone from working and enjoying life. It can also lead to feelings of isolation, anger, frustration, and guilt.3
There is some speculation that psychological issues are the root of chronic pain. However, research suggests that chronic pain is linked to abnormalities between the hypothalamus, pituitary glands, adrenal glands, and the nervous system. Their interaction is known as a stress axis. This stress axis controls the body’s reaction to stress, injury, and trauma. Abnormalities may explain why pain is experienced differently from person to person. 2
Additional studies have found that there are abnormally low levels of endorphins in the spinal fluid of people who experience chronic pain. These endorphins are chemicals in the body that naturally help to control pain the body experiences. 2
Symptoms of chronic pain can vary from person to person.
The debilitating nature of chronic pain creates the necessity of treatment for people living with chronic pain. In most cases, doctors prescribe opioids to treat chronic pain. However, some patients may develop an opioid use disorder as a result of opioid treatment. In cases where the risk for developing addiction is high, there are alternative and effective treatment methods that can be used.
An opioid is any compound that binds to opioid receptors in the brain. Opioids have been regarded as one of the most effective drugs for pain treatment for many years and throughout history. Professionals have long considered opioids the standard of care when dealing with acute severe pain and chronic pain. 7
Opioids work by binding to opioid receptors, which are widely distributed throughout the brain. Opioid receptors related to pain are located in the central nervous system and the peripheral nervous system. When opioids are administered and bind to opioid receptors, they help reduce pain and create other side effects. Side effects can include constipation, itching, mental clouding, and respiratory depression. 7
Opioids can also produce mood effects, such as dysphoria or euphoria, and bind to receptors involved in reinforcement and reward. Many individuals who use opioids for pain treatment are not affected by the change in these systems. However, in some cases, powerful reinforcement occurs and can result in cravings and positive mood effects, including euphorigenic or pleasurable effects. These effects could be associated with addiction. 7
The effects on the reinforcement and reward system in the brain associated with opioids as a treatment for chronic pain can create addiction issues in patients. It is crucial to understand the threat of addiction associated with opioids as a treatment for chronic pain, considering the severity of opioid use disorder.
The American Medical Association estimates that 3% to 19% of people who take prescription pain medications develop an addiction. Patients who develop an addiction to prescription painkillers may seek other forms of opioids, such as heroin, when it is more readily available. Almost 45% of people who use heroin were first addicted to prescription opioids. 8
In 2017, over 72,000 Americans died from drug overdoses. Nearly 30,000 of these overdose deaths involved fentanyl and fentanyl analogs, almost 16,000 involved heroin, and practically 15,000 involved prescription painkillers. Also in the year 2017, the opioid crisis was declared a nationwide Public Health Emergency. 8
The CDC has developed guidelines for prescribing opioids to reduce the number of people who misuse or overdose due to opioid treatment. Part of what these recommendations focus on is the use of opioids to treat chronic pain.
While many doctors may choose to utilize these guidelines, some doctors may have their own methods for prescribing opioids and may not be as thorough in their approach. In some instances, a patient, their family members, or their doctor may find that it is in the patient’s best interest to choose an alternative treatment method, especially if the patient is at risk for developing an opioid use disorder.
If you or someone you love is experiencing symptoms associated with opioid use disorder, it is important to seek treatment. There are various treatment methods that can be utilized when dealing with an addiction.
Different types of counseling include: