Opioids are a dangerous way to treat pain, experts warn

When you hurt, you want relief. And you can get it, often, by taking a prescription painkiller known as an opioid. But with opioids come risks.

Health care agencies, insurers and health care providers are coming increasingly to the same conclusion: Opioids may help solve a patient’s problem with pain in the short term, but they can cause an array of troubling new issues, from addiction to overdoses.

A couple of new studies reinforce the growing consensus:

• A Centers for Disease Control and Prevention analysis of patient records found that patients who receive refills of their first opioid prescription were more than twice as likely to continue taking opioids a year later than people who didn’t get refills.
• A study published in the BMJ (formerly the British Medical Journal) found that people who took opioids while also taking benzodiazepines were more likely to overdose than those who didn’t take both drugs at the same time. Benzodiazepines are a class of drugs that works on the central nervous system, commonly prescribed to treat anxiety and insomnia.

Legally prescribed opioids, such as Vicodin and OxyContin, are prescribed to help patients manage pain. Heroin is an illegal opioid.

Federal health agencies, such as the Department of Veterans Affairs and the CDC, have advised health care providers to restrict the dosage and duration of opioid prescriptions, and private insurers sometimes refuse to pay for high-dose prescriptions. The American College of Physicians recently issued new guidelines discouraging the use of opioids to treat lower back pain.

“For pain that continues long after tissues have healed – or in the absence of an injury – painkillers are proving to be less helpful,” says Nora Stern, program manager for the Providence Persistent Pain Project. “In fact … they often make pain and daily life worse.”

To learn more, read this earlier post: “Prescription painkillers: 10 things you need to know”

What opioids do

Opioids work to treat pain because they attach to receptors in the brain, sending signals that block pain, slow breathing and provide a generally calming, anti-depressing effect. They activate nerve cells and “lead to abnormal messages being transmitted” through the neural network.

They activate the brain’s reward system by pushing dopamine – a naturally occurring chemical compound – into the system. This provides the pleasurable rush craved by addicts of legal and illegal opioids.

If you or a family member needs treatment for pain, discuss the risks of opioids with your health care provider. And if you or a family member is relying too heavily on a painkiller, talk to your provider about how to stop.

You can find a Providence provider in our directory.

Some encouraging trends

Researchers are at work on alternative medicines for pain relief. The National Institute on Drug Abuse recently noted a pair of “promising advances in the search for safer opioids.” The studies have the potential to develop effective treatments for pain that don’t carry the risks for addiction and overdoses that accompany opioids, the institute noted.

Also, a study of prescription opioid exposures to children shows that exposures – often accidental and occurring in the household – have been decreasing since 2009. The study was published in the journal Pediatrics.