How long have you been suffering from chronic back pain? Have you been prescribed opioids for the pain? How long have you been taking them?
Treating chronic pain is a very pattern-driven process. Too often, we confuse the “most available” treatment with what is best for us. It is easy to get caught in a loop of continuous pain-relieving opioids, and before we know it, a year has passed with no relief. Additionally, some studies indicate that opioids are not effective at relieving chronic back pain, and they can also have long term health complications that might not necessarily be advertised.
How Do Opioids Provide Pain Relief?
Opioid medications bind to opioid receptors in the brain and spine to block “pain signals” sent by the body’s nervous system. They also support the release of dopamine which leads to feelings of relaxation and comfort.
Are There Any Negative Side Effects of Opioids?
Are Opioids Effective?
We can view pain in one of two ways. The first way is to accept pain at face value and focus on treating it directly. But, "pain" is not a diagnosis...it is a symptom.
The second, is to realize that pain is an indicator/symptom of a loss of function. For example, if someone is experiencing lower back pain, we can view it simply as “pain”, or it can be viewed as a symptom of a degenerating disc and osteoarthritis between the lumbar vertebrae. Therefore, it isn’t effective to clinically prescribe something for the pain, when the actual problem is the lumbar loss of function. However, prescribing an opioid, or even a general anti-inflammatory, is the sometimes most available option and that’s what sticks.
2020 in America finds us amid an opioid outbreak. Opioids are more accessible, and therefore more unregulated than they have ever been. But, despite their growing popularity, scientific evidence continues to emerge arguing that opioids may not be effective at relieving pain.
For example, the JAMA Study, "Opioids No Better Than Nonopioids 9n Improving Discomfort Relevant Function, Strength for Chronic Back Pain, Hip/Knee OA" studied 240 individuals to discover that opioid pain relievers had little to no effect.
The individuals experiencing chronic pain were split into 2 groups, the very first group was administered opioid medication and 2nd team received non-opioid medicines. After twelve months symptoms and comfort levels were significantly higher in the group that received non-opioid medications. The group that was administered opioids had significantly higher pain levels and several members had developed serious side effects (nausea, vomiting, depression, and insomnia).
Opioids operate using the same mechanisms (binding to receptors and the release of neurotransmitters) as other drugs. With those mechanisms, comes the potential for tolerance/dependence. This becomes a very dangerous slope for two main reasons: 1) Anytime we feel pain, we immediately reach for opioids as a natural response and 2) Because we've been taking opioids regularly for a long period of time, we've become less sensitive to them, and therefore have to ingest more to yield the same results.
In summation, the purpose of this entry is NOT to discredit Opioids. We simply want to inform each individual of some of the complications and encourage to consider all options. As usual, be sure to consult your primary care physician with all of your medical needs!