How to manage chronic pain and use of analgesics

Think back to the last time you scraped your knee or had a toothache. It probably hurt a lot, but after a while, the pain went away.

Now, imagine if the pain didn’t go away but stayed for weeks, months, or even longer. This type of long-lasting pain is called chronic pain and can be very difficult to live with.

Doctors often use strong pain relievers called opioids to help people with chronic pain. These medications can be very helpful, but they also carry risks, especially when used for a long time.

You may have heard about opioids in the news, as they can lead to addiction or other serious problems if not treated carefully.

Recently, the US Department of Veterans Affairs (VA) and the US Department of Defense (DoD) released new guidelines on how to use these powerful drugs more safely.

These guidelines are based on research by Dr. Friedhelm Sandbrink and his team and were published in a medical journal called Annals of Internal Medicine.

Why are these guidelines important?

The goal of the new rules is to help doctors and patients manage chronic pain without over-relying on opioids.

Over the years, doctors have learned that while opioids can be effective in reducing pain, they are not always the best or safest option, especially when the pain is not related to cancer or other serious conditions.

The team of Dr. Sandbrink created 20 specific recommendations on how to use opioids more responsibly. Here are the key points:

Opioids should not be the first choice: When a person has chronic pain, especially pain that is not related to cancer, opioids should not be the first treatment a doctor turns to. There are many other treatments that can be tried before prescribing these strong drugs.

Avoid long-term use: If opioids are needed, they should only be used for a short period. Prolonged use of these drugs increases the risk of addiction and other negative side effects. This is especially important for younger people or anyone who has had problems with drug misuse in the past.

Do not mix with other risky medications: Combining opioids with another type of medicine called benzodiazepines (used to treat anxiety and sleep problems) can be very dangerous. The new rules make it clear that this combination must be avoided.

Use the lowest dose for the shortest time: If opioids are prescribed, doctors should give the smallest possible dose and only for as long as absolutely necessary. This reduces the risk of patients becoming dependent on the medication.

Frequent revisions: After someone starts taking opioids, they should return to their doctor within 30 days to discuss how they are doing. If they need to continue using the medicine, they should continue to have regular follow-up appointments to monitor their health.

Other treatment options

An alternative to the opioids mentioned in the guidelines is a medication called buprenorphine. This drug is less strong than many other opioids and carries a lower risk of addiction, making it a better choice for some people.

Why all the caution?

The main idea behind these new rules is to be very careful when using opioids. Although they can help control pain, they can also be dangerous if not used correctly. Dr. Sandbrink and his colleagues note that in many cases, the benefits of these drugs are small compared to the risks.

For example, people who take opioids for long periods can develop tolerance, meaning they need more of the drug to get the same effect. This can lead to dependence or addiction. There is also the risk of overdose, which can be life-threatening.

By following the new guidelines, doctors can make sure they’re helping patients without putting them at risk. Patients also benefit because they will be more informed about the risks and how to use opioids safely.

What does this mean to you?

If you or someone you know is dealing with chronic pain, it’s important to understand that there are many ways to manage pain.

Opioids are only one option and should be used with caution. If a doctor prescribes opioids, it’s a good idea to ask questions and make sure you fully understand how and when to take the medication.

Chronic pain can be difficult to live with, but it’s essential to find a treatment that works without causing more damage. By being informed and working closely with healthcare providers, patients can make the best choices for their health and well-being.

This new set of rules is an important step toward safer pain management. It helps doctors and patients use opioids responsibly, reducing the risk of addiction while providing relief to those who need it.

Always remember that when it comes to your health, it’s important to be informed and make sure you’re getting the right care.

If you’re concerned about pain, read studies on vitamin K deficiency linked to hip fractures in older adults, and these vitamins could help reduce the risk of bone fractures.

For more on wellness, see recent studies that krill oil could improve muscle health in older adults and eating yogurt linked to less frailty in older adults.

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