The top 5 things to know about opioids
While a decade ago you may not have heard much about opioids, today they make headlines daily. The nationwide epidemic crosses generations and socioeconomic lines, and it's affecting your family, friends and neighbors.
"Opioids have long been used clinically to treat pain, but prior to the 1990s they were primarily reserved for patients with a limited life expectancy, such as for someone with cancer or in a hospice setting," says Dr. W. Michael Hooten, a Mayo Clinic anesthesiologist and Pain Clinic specialist. "The potential problems associated with long-term use were secondary considerations."
To help shed light on this growing national problem, Dr. Hooten lends his expert insight on what people need to know about opioids.
Opioids are prescribed for various reasons
Opioids are used to treat a variety of pain disorders. While they are commonly prescribed after an operation, opioids are also used to treat a host of chronic pain conditions including musculoskeletal, abdominal, pelvic, and neuropathic pain.
Length of use varies
"Following surgery, up to one in four patients may use opioids longer than anticipated," says Dr. Hooten. "How long, exactly, depends on several clinical factors."
He notes that after an operation, a patient might use opioids to manage acute pain for three to five days. "When opioids are used for acute postoperative pain, patients should try to use the lowest possible dose." After this short time period, opioids should be replaced with non-opioid pain medicines including Tylenol scheduled to be taken every six hours."
There are alternatives for pain management
There are many alternative options for chronic pain. Dr. Hooten suggests talking with your doctor about:
- Non-opioid analgesics (non-opioid pain medications).
- Interventional treatments such as image-guided spine injections or nerve blocks. * Acupuncture.
- Low-impact exercise such as walking, yoga, Pilates. Consider working with a physical therapist to develop a structured exercise program.
- For advanced pain treatment, spinal-cord stimulation can disrupt the pain stimuli and provide sustained pain relief.
- Work with a pain psychologist who can help teach individuals how to use specialized behavioral and cognitive techniques that could lead to improvements in daily functioning and quality of life.
Opioids can be deadly if misused
"Approximately 90 people per day die in the U.S. from a prescription opioid and/or an illicit opiate overdose," says Dr. Hooten. Many of those are accidental overdoses. “People who take prescription opioids will inadvertently mix them with benzodiazepines (e.g., Valium and Xanax). Dr. Hooten warns that these two drug classes should never be taken together, as the combination can suppress the central nervous system and put the individual at risk of an accidental overdose.
Addiction can happen to anyone
As Dr. Hooten notes, “No one plans to get addicted, but it happens. Using opioids requires a high level of vigilance for the signs and symptoms of addiction."
There are many signs of over-reliance or misuse that families should be aware of. These include an increased preoccupation with the drug, concern about the timing of the next dose or refill, hiding use of the drug, and signs of intoxication like slurred speech and excessive sleep.
If you notice these warning signs, alert your loved one about your concerns. "This might be enough to prompt a change," says Dr. Hooten. "Otherwise relay this information to the prescriber and tell them what’s going on. They can take the correct next steps."
For more information on pain medication and alternatives, or to make an appointment, visit www.mayoclinic.org.