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Opioids: Examine the Risks, Benefits, Alternatives

Pain. It’s an unfortunate, often highly impactful, fact of life. Some pain is in the moment, like stubbing your toe or accidently touching a hot surface. Some pain can be lasting, such as back, knee, nerve and neck pain. Because of these things, most people will need a version of pain control at some point in their life. There may even be a point where a medical provider suggests an opioid (such as Percocet or OxyContin) to manage pain on a short-term basis.
Opioids have been the focus of much media attention and public information for about the last 10 years. They are credited with sparking this country’s most devastating addiction, overdose and death crisis in known history. And although nearly every person walking the planet is aware of this, how much do we, as a culture, actually know about the medication? Let’s start with a few important things:

1) Opioids can be an effective, short-term pain management tool for many people.

2) Opioids may not be the most effective form of pain management.

3) Opioids can quickly create tolerance, causing reduced effectiveness within a relatively short period of time (days to weeks).

4) Any exposure to opioids increases the risk of long-term use, dependency, addiction and/or overdose.

5) Even when taken as prescribed by a medical provider, opioids can create physical dependence or addiction.

6) There are effective alternatives to opioids that carry less risk.

Because the medication can be effective short-term, a medical provider may offer an opioid prescription for such things as surgical pain or more serious injuries. Should this happen, it is excellent practice to have a discussion with that provider about the risks, benefits and potential alternatives to opioids. So, here are a few tips:

Talk to the doc: If your medical provider suggests an opioid for short-term pain, here are some good questions to ask. (This article does not contain medical advice. These are conversation starters.)

• What is the lowest effective dose I can take?

• Are there alternatives to this medication that may help me manage pain?

• What are my specific risks related to this medication?

• Should I be concerned about interactions with other medications, supplements or alcohol?

If you are seeing a medical provider about a long-term or chronic pain issue, here are some common alternatives to opioid pain medication that you may wish to inquire about:

• Over-the-counter medications

• Non-medication pain management tools such as exercise, therapeutic massage, acupuncture, counseling, weight management, yoga, tai chi and stress management

• Physical therapy

• Other prescription medications (non-opioid)

Pain is not a simple inconvenience. It can be a seriously impactful quality of life issue in the lives of many. And, often, it is a quality of life issue that is invisible. We can’t necessarily see when an individual is in pain. People who are in pain often suffer in silence because pain can be too often minimalized by people in their lives. It is not minimal—it matters.

What is important to know is that pain management has come a long way. Medical providers have a wide arsenal of tools at their disposal to help. An opioid may be the best option in the moment, and it may not be. The discussion is everything. Providers, more than anyone, know the reality of pain and its impact on overall health. They are our allies in helping us to get better and feel better.

The next time you get to talk to your provider about any pain you might be experiencing, write your list and expect to be heard.

Julie Dostal is executive director of the LEAF Council on Alcoholism & Addictions, Oneonta.