Chronic Pain? The Balanced Truth about Prescription Pain Killers

Prescription pain killers, like opioids, have become a widely sought after treatment for pain. They are generally considered as the standard solution to chronic and acute pain around the world. However, concerns have arisen about the long-term use of these pain killers and people are starting to question the safety, effectiveness and the likelihood of abuse that may go along with their use. (Rosenblum et. al., 2008) (Martell et. al., 2007)

How do prescription pain killers work?

In the body, opioids bind to opioid receptors (specific proteins that are distributed throughout the body) in order to elicit the desired reaction. The ones that are involved in the modulation of pain are found in the central and peripheral nervous systems. The opioid receptors are also binding sites for endorphins, which are involved in many functions in the body including the modulation of reward and reinforcement mechanisms, mood and stress. (Rosenblum et. al., 2008) Opioid receptors are furthermore located on certain cells of the immune system. (Bidlack, 2000)

Why do prescription pain killers have side-effects?

When an opioid pain killer is given for pain, it may bind to any of the opioid receptors that are found in various locations in the body. Therefore, pain relief may very likely be accompanied by side-effects that result from the activation of opioid receptors that are involved in other functions in the body. These side-effects may be mediated by central or peripheral mechanisms and may include anything from constipation, itchiness, pupillary constriction, mental clouding, sleepiness and breathing problems. Furthermore, opioids may also cause mood effects like euphoria or dysphoria. (Rosenblum et. al., 2008)

 

Other draw-backs of prescription pain killers

Even though prescription pain killers are a popular treatment option for pain relief, a few factors may make them a less than preferred treatment option for the relief of chronic pain. Let’s have a look at some of these factors. (Ballentyne et. al.,2007)

Pharmacologic tolerance

People may develop tolerance to the anti-pain effects of prescription pain killers.

Opioid induced pain

Hyperalgesia (or severe pain) may develop during the withdrawal period when opioid treatment is stopped.

Withdrawal

When opioid treatment is discontinued, you may suffer from the physical and psychological effects of opioid withdrawal syndrome. These symptoms include insomnia, psychomotor agitation, irritability, goose bumps, diarrhea, depression and ironically, severe pain.

Psychological factors

The pain relieving properties of opioids can be altered in relation powerful psychologic drivers, circumstances, learned behaviors and the environment.

 

What other possible treatments are there for chronic pain?

If you suffer from chronic pain, do not despair, many alternative treatments are available to help with the management of chronic pain like hypnosis, biofeedback and cranial electrotherapy stimulation (CES). These therapies have gained popularity in the past few years. (Tan et. al., 2007)

Hypnosis

Research has shown that hypnotic pain relief has a greater impact on the reduction of pain when compared to medical interventions.

Biofeedback

Electronic biofeedback devices (noninvasively) record minute changes in physiological functions from (for example) the skin. These days, clinicians are exploring the possible efficacy of neurofeedback for the management of pain and a large amount of successful reviews have been published on the use of biofeedback for pain management.

Cranial Electrotherapy Stimulation (CES)

CES involves the application of small amounts of current through the head through electrodes that are clipped to the ears. Since the 1990’s, CES has been gaining popularity as a complementary intervention for the management of chronic pain.

So think twice before opting for prescription pain medication and rather seek out alternative therapies that are just as effective without serious risks involved.

by Guest Writer – Mariska Smith

References:

Ballantyne JC, Shin NS. Efficacy of opioids for chronic pain: a review of the evidence. The Clinical journal of pain. 2008 Jul 1; 24(6): 469-78.
Bidlack JM. Detection and Function of Opioid Receptors on Cells from the Immune System. Clinical and Diagnostic Laboratory Immunology. 2000; 7: 719–723.
Martell BA, O’Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, Fiellin DA. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Annals of internal medicine. 2007 Jan 16; 146 (2):116-27.
Rosenblum A, Marsch LA, Joseph H, Portenoy RK. Opioids and the treatment of chronic pain: Controversies, current status, and future directions. Exp Clin Psychopharmacol. Oct 2008; 16(5): 405–416.
Tan G, Jensen MP. 6 Integrating Complementary and Alternative Medicine into Multidisciplinary Chronic Pain Treatment. In chronic pain management: Guidelines for multidisciplinary program development 2007 Jul 26 (pp. 775-799). Informa Healthcare USA, New York.

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