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Opioid Safety and Pain Management: What You Should Know

By: Serena Curler MSN, ARNP, ACNP-BC, ACHPN at UnityPoint Health - Trinity Pain Clinic.  

The opioid epidemic in America is evidence that change is needed in how we think of pain and treat pain. Opioids are often effective in treating acute pain. For chronic, non-cancerous pain, however, there is little evidence showing the effectiveness.

Chronic pain management is a marathon. For that, there are lower risk treatments available and non-opioid options. Some of the more technical and advanced treatments available are steroid injections, various types of epidurals, nerve blocks, kyphoplasty, radiofrequency ablation, implantable spinal cord stimulation systems, and even implantable pain pumps. But, sometimes, low dose opioids are necessary.

What is safe use of opioids? Be sure to take the medicine only as prescribed and only when absolutely needed. Providers rarely prescribe long acting opioids for non-cancerous pain. If one tablet does not help the pain, taking more may not help either and only increases the risk of breathing problems, over sedation, and death. Simply, if it is not helping, do not put these chemicals in your body. If used over time, opioids will become ineffective. This becomes a larger problem for chronic pain sufferers if they have a new pain that needs to be treated.

Always safe guard medications. This means locking up your pill bottles. Be sure they are not within reach of a child. If the person needing them is not able to manage them, such as with an older adult, be sure to follow these same tips. Be sure they are not visible to others who may steel them (such as storing them in a car). Do not share your medicine with anyone. What is safe for you, may not be safe for another. If you are no longer needing the medicine, the police station or pharmacy may safely waste the medication. If you are a patient at the pain clinic, bring in your pain pills. You can waste them at home by crushing and mixing them in coffee grounds before disposing in a tightly closed plastic bag.

Know your limits. Know your pharmacy. Patients should not drive or operate machinery while taking pain medicine. Always fill your medicines at the same pharmacy. This allows your pharmacist to review your medicines for potential deadly interactions. While your provider checks what other medicines you are taking, sometimes, your provider may not be aware of what other providers are prescribing for you. Benzodiazepines, or anxiety medications are dangerous while on opioids. Other medications can increase the risk of serious events such as seizures or heart rhythm problems.

Chronic pain is often complex. The cause can be challenging to pinpoint and treat.  Often, such patients are referred to a pain management specialist. Pain physicians put together the story or history of the pain, the physical exam, and relevant images. Previous treatments are discussed. Through this discussion, we learn how the pain is impacting one's life. We help patients to understand where the pain is coming from and what options are available to improve daily functioning.

Lastly, a key factor in improving pain is the patient themselves at the center of the plan.What have you tried to help the pain? How far do you want to go with treatment? A holistic approach to pain management is the most successful. Research has shown that psychological wellbeing is a predictor of how well pain is controlled. Lifestyle changes are impactful. What we do with our body, good or bad, influences pain.

You may also visit www.fda.gov or www.cdc.gov for more information.