This post is part one of a two-part series on alternatives to opioids.
Earlier this summer, the Willingway blog released a three-part series on how the opioid crisis started, what it looks like in 2017, and where it’s headed. In those posts, one common scenario was posed about how an individual can become addicted to opioids:
“A patient goes to see a doctor about back pain. Or, maybe he just needs some minor surgery. The doctor wants to help him manage the pain, so a strong pain reliever is prescribed (Vicodin, Oxycontin, etc.). The patient takes the pills and relieves his pain. Before long, he develops a dependency on the pills. Eventually, the bottle runs out. The patient is left with an addiction and seeks out the next available opioid.”
However, there are other paths towards opioid dependence. If you or a loved one suffers from chronic pain, postoperative pain, or other chronic conditions you may be prescribed a strong opioid pain medication – even in a medical environment where many doctors are more careful about the prescriptions they write.
The risk of developing dependency is real, but there are viable alternatives to opioids available to help manage and relieve pain. This post will present some of those options and sources where you can learn more.
If you are ready to begin researching “alternatives to opioids,” know that you are not alone. According to NPR Health, “Chronic pain affects more Americans than cancer, heart disease and diabetes combined.” Some patients, like Britt Johnson, use a low-intensity opiate to abate the worst of their pain but find personal practices like meditation, yoga, and breath work to be helpful supplements.
Nonetheless, Johnson and many others continue their research on other pain treatments less often offered in the traditional doctor’s office. The National Center on Addiction and Substance Abuse provides an efficient outline of psychological (and non-opioid) methods to treat pain: biofeedback, hypnotherapy, and Cognitive Behavioral Therapy. Their overview of these three methods is adapted here:
- Biofeedback – Biofeedback is a method in which individuals learn to better control symptoms by monitoring body experiences that are usually outside of their awareness, like heart rate or blood pressure. In the case of pain, people are taught, with the assistance of medical technology, to look for cues of their discomfort, become more aware of their symptoms, and adapt to control them.
- Hypnotic analgesia – Also known as hypnotherapy, hypnosis works by making patients aware of the source of their pain, underlying issues that make it worse, and the ways they can better manage it. This method can be administered by a medical professional, or individuals can be trained to self-hypnotize (which has yielded results similar to biofeedback).
- Cognitive Behavioral Therapy (CBT) – CBT is a psychological treatment that helps alleviate pain and depression by identifying dysfunctional thoughts or attitudes and developing coping mechanisms. A brief history and explanation of this already somewhat commonplace treatment is available here.
In Maryland, at the Greater Baltimore Medical Center, a team of doctors is taking an innovative approach to reducing opioid use for their patients. Called “enhanced recovery,” the procedures include:
- Providing “non-addictive” painkillers before and during surgeries
- Placing a “nerve block” in the surgery area to prevent pain from spreading
- Encouraging patients to get up and get moving sooner after surgery than typical recovery methods
- Giving less IV fluids
The combined effort has already proven effective at curbing the need for the strongest opioids.
Another important alternative to take into consideration is medicinal marijuana. This treatment is not for everyone, but at its core it does offer pain relief with few side-effects when compared to opioids. Depending on what state you live in and what your condition is, you may be able to consult with your doctor about a prescription.
Reading about medical marijuana online can be overwhelming; there is an enormous amount of material available. As a means of entry, check out this easy-to-use beginner’s guide from Project CBD. Also, because this treatment is relatively new on the market and still steeped in controversy, it’s valuable to consider both sides of the debate. ProCon.org provides the most comprehensive and unbiased overview on the points in favor and against marijuana for medical use.
Alternatives to opioids for pain management and relief abound. Sometimes your doctor may not be aware of all the possibilities, so stay informed. Also, stay tuned for the next Willingway blog post which will explore exciting new treatments still in development.
A randomized controlled trial of hypnosis compared with biofeedback for adults with chronic low back pain. ResearchGate.