Opioids are strong prescription drugs that work as pain relievers in the body by blocking pain receptors in the brain and releasing an endorphin rush, leaving the patient to feel calm and relaxed. This drug is notorious for its addictive qualities due to the feeling of euphoria it produces. The addiction risk and rate of taking an opioid is high due to the enhanced feelings of euphoria that require more and more of this drug to create. In fact, in 2018, close to 70 percent of all drug overdose deaths were linked to opioids.
Opioids are designed to relieve high-level pain in patients who are recovering from a surgery, which is considered acute pain, or help patients with chronic, or continuous illnesses like cancer. These chronic and acute pain examples are ones that are known to produce a high level of pain, and patients oftentimes need assistance in coping with this pain when reverting back to daily activities.
About 21-29 percent of patients with chronic pain disorders who are prescribed opioids will misuse them. In 2017, 191 million opioid prescriptions were prescribed to patients. In the year prior, it was reported that 11.5 million Americans were addicted to opioids.
In 2018, the CDC updated the guidelines from 2016 urging healthcare professionals to reduce the number of opioids prescribed to the lowest possible effective dose, and to avoid prescribing opioids as a first-line treatment for chronic pain.
Reduction in prescriptions makes sense — the U.S. is the world leader in opioid use by a factor of 400 — but the question remains: what about the people suffering from pain?
The CDC provides other forms of pain management in its guidance, including physical therapy as a viable alternative for many people who struggle with daily pain.
While there are cases when these medications are absolutely appropriate, dependence on a highly addictive narcotic for long-term pain relief is not the answer. The Results approach to physical therapy not only alleviates pain in the short term, but it also educates the patient on how they can maintain their health and well-being for the long term. It focuses on eliminating the cause of a patient’s pain, not just managing the symptoms.
One of the causes of the opioid epidemic to the over-prescribing of these drugs without consulting other options like physical therapy as alternate form of treatment. A study found that patients who received a physical therapy referral from their physician for lower back pain were 35 percent less likely to receive opioids for one year following their doctor’s visit.
In the 1990s, pharmaceutical companies assured physicians that opioids were not addictive and were safe to distribute to patients, so medical companies increased their prescription rate to patients based on this false promise. Once a patient ingests a dose of opioids as treatment, it is more likely the patient could become addicted to these pills or potentially transfer onto more extreme synthetic opioids like heroin due to a lack of prescription medication.
“Chronic pain also is influenced by psychosocial and psychiatric disturbances, such as cultural influences, social support, comorbid mood disorder, and drug abuse. Classic studies of pain behavior indicate that cultural differences in the beliefs and attitudes towards pain and the social/environmental context of the pain have a significant impact on pain behaviors.”
Outside factors can also contribute to one’s need or perceived need to take prescription opioids when suffering from a chronic illness or pain. Additionally, if someone is recovering from drug use, they are more likely to relapse if placed in a stressful situation because many times there are little to no other coping skills due to the strength of the opioids in rewiring the brain pathways. One idea to combat the over-prescribing of opioids is to consider less-addictive methods of treatment like physical therapy or less harmful prescription drugs and for a shorter period of time to relieve pain.
Physical therapy has many health benefits for individuals who suffer from chronic conditions or who are recovering from an acute injury. Physical therapy allows patients to work with a physical therapist to get to the root of the issue and use hands-on therapy to make physical adjustments to support proper body functioning. For example, with physical therapy you can conquer your chronic headaches and understand that your poor posture was putting too much pressure on your neck, causing constant cervicogenic headaches. Instead of taking prescriptions daily, physical therapy allows a professional healthcare provider to provide hands-on care to alleviate their patients’ pain.
Most states allow direct access to physical therapy care for patients across America. Because of this, patients are able to save time, money and effort when choosing physical therapy first. Many states are not requiring a physician’s recommendation when attending physical therapy, which means that the power is in the care of the patients’ when receiving care. Using physical therapy as a first line of defense negates any of the side effects that are common when patients become reliant on opioids as a coping mechanism.
Opioids are known to have many dangerous side effects when misused and abused such as:
Out of all the countries in the world, citizens of the United States are forced to pay more for prescription drugs than anyone else in the world, averaging $1,200 per year per person. On average, cancer drugs cost about $10,000 a month and some of this burden falls onto the public via increased premiums and taxes. The large pharmaceutical companies who are raising prices often due to little or no competition are facing backlash from the individuals who are burdened by these prices as well as insurance companies who take on even more direct financial responsibility. In fact, since the end of December 2019, over 560 prescription drug prices have raised on average 5 percent.
The rise in medicine prices are hitting the older Americans on Medicare the most. The CEO of AARP, Jo Ann Jenkins states, “Current drug prices are not sustainable. Medicare beneficiaries live on an average annual income of just over $26,000. Meanwhile, the average annual price for a specialty drug used for a chronic condition is now nearly $79,000. No one can afford medications that cost more than their annual income.”
However, it appears that the government heard the voices of concerned citizens who were outraged by the climbing prices of prescription drugs in 2019. In July of 2020, an executive order was passed designed to lower prescription drug prices for Americans. This bill includes giving senior citizens discounts, which in 2018s totaled around 30 percent off medication to a community of people with the highest need for medicine.
Consider talking with your healthcare professional about which medicine is right for you and if a more holistic method, such as physical therapy would benefit you greater. Everyone should be equipped with knowledge about the pros and cons of opioids to see if prescription medicine is what is right for them and their condition.
We’ve highlighted some opioids and prescription drug stats that might shock you.
Categories Of Opioids
In 2012, health care providers wrote 259 million prescriptions for opioid pain pedication.
This is enough for every American adult to have their own bottle of pills.
Sales of prescription opioids have nearly quadrupled since 1999
Opioid-related deaths have nearly quadrupled since 1999
At least half of these deaths involved a prescribed opiod.
From 2000 to 2014 nearly half a million people died from drug overdoses
The majority of drug overdose deaths (more than six out of ten) involve an opioid.
Every day, more than 1,000 people are treated in ER departments for misusing prescription opioids
Opioids are largely ineffective for lower back pain
People with chronic low back pain may get short-term relief from opiods, but evidence does not support long-term effective treatment.
Using opioids for more than 30 consecutive days may increase risk for depression
People addicted to prescription opioids are 40 times more likely to become addicted to heroin
Heroin-related overdose deaths have more than tripled since 2010.
We’ve compiled some of the most helpful and frequently asked questions for patients who are considering using physical therapy to overcome their chronic pain.
For chronic pain conditions, the ultimate goal is to improve your ability to function throughout your daily life. A physical therapist takes the time to educate you on your condition, as well as aggravating and relieving factors, and improve your ability to independently manage your pain after completing your care plan. Individuals who participate in physical therapy significantly increased their ability to cope with pain. They improve their ability to be active, healthy, and involved members of their communities. In fact, research suggests that the best self-management programs teach people different ways of thinking about and responding to pain, making their actions to relieve it more effective.
Common side effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. Chronic use of opioids may also lead to liver damage, and brain damage resulting from respiratory depression. Becoming dependent on or addicted to opioids runs the risk of causing withdrawal symptoms once usage is decreased or discontinued.
The CDC recommends nonopioid approaches such as physical therapy to manage pain in their opioid prescription guidelines. These guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed. Our physical therapists are able to determine if physical therapy may be right for you during an evaluation.
No. All 50 states allow evaluations by a physical therapist, though some states have restrictions about the treatment a physical therapist can provide without a physician referral. Check out APTA’s direct access summary chart (.pdf) to see the restrictions in your state.
Chronic pain affects each person differently but can be described as discomfort or an unpleasant sensation that lasts for three or more months. The pain can range from mildly inconvenient to completely debilitating and can be either continuous or episodic.
Your heatlhcare professional wants you to live without pain. You should feel confident in asking your doctor if there are viable options to treating your pain other than opiods, such as physical therapy.
To help prepare yourself for your visit we recommend making a list of questions you have for your doctor and filling out our pain assessment worksheet to bring with you to your appointment.
One of our physical therapists at Results put together a great video talking more about opioids and the effect prescription medicine has on patients. The video also highlights some of the reasons why patients should consider physical therapy over prescription medicine and opioids when looking to treat and overcome their chronic pain. Watch this video here: https://resultspt.com/opioids-video
At Results Physiotherapy, we’re passionate about helping patients alleviate their chronic pain over time and reduce their dependence on prescription drugs. We’ve got an amazing Opioids Patient Success Story and Opioids Patient Testimonial we highly encourage you to look at.
Physical therapy can help you overcome some of the chronic pain you’re experiencing, as our physical therapists are passionate about identifying the root cause of the underlying issue and working to help get you better, faster. Schedule an Appointment Today to connect with a physical therapist today to deal with your chronic pain.
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