Prescription painkillers are one of the most commonly used methods to treat chronic pain. Research has shown that the most commonly prescribed pills, opioids, are risky and sometimes fatal.

At Arizona Pain, we believe in reducing your pain while improving your quality of life, and we’re often able to do that without opioids. A range of pill-free techniques, alternative therapies, and lifestyle modifications often help to greatly reduce pain. That said, some patients do benefit from using prescription painkillers.

Those patients of ours who do take opioids are carefully watched to ensure they take the lowest dosage possible while ensuring relief. It’s only after lower risk treatment options have failed that we look to opioids, and even then we combine with as many other therapies to keep dosage as low as possible.

Unfortunately, not all patients enjoy this same level of oversight. Research has discovered that about 90% of patients who survive opioid overdoses, for example, go on to receive brand new prescriptions for the same pills that almost killed them.

It’s not all bad news, however. New research has also uncovered a promising new mix of non-addictive medicines that do more than dull the brain’s reaction to pain, but work to heal the brain damage the pain has caused.

1. Opioids are ineffective for some back pain patients, researchers say

For chronic back pain, taking prescription painkillers may seem like a quick solution.

However research from the American Society of Anesthesiologists has discovered that the pills aren’t effective for all patients. Specifically, those with depression or anxiety may not experience the same reduction in pain as people without the mood disorders.

Even more dangerous, those with mood disorders were more likely to abuse the pills, possibly leading to addiction and worsening mental health problems. Study author Dr. Ajay Wasan tells ScienceDaily:

“High levels of depression and anxiety are common in patients with chronic lower back pain…Learning that we are able to better predict treatment success or failure by identifying patients with these conditions is significant.”

In the study, researchers examined 55 people with chronic lower back pain and found those experiencing significant depression or anxiety saw 50% less pain relief and a whopping 75% increased risk for abusing pain pills. They also suffered from worse side effects.

Researchers said it’s important for doctors to take mental health concerns into consideration when deciding whether to offer prescription painkillers.

2. Patients who survive prescription painkillers overdose are still prescribed the medicines by their doctors, study finds

Part of the danger of opioids lies in the potential for overdose and death. Fortunately, not everyone dies after an overdose, but unfortunately, many doctors continue to prescribe opioids to patients who survive, according to research from Boston University Medical Center.

Patients who have experienced one overdose are at high risk for a second. Continued access to opioids contributes to that risk. Study authors said doctors need better tools to limit overdose survivors’ access to prescription painkillers.

For the study, researchers sorted through millions of insurance claims and examined the profiles of 3,000 chronic pain patients who received prescriptions for opioids and had been treated in the hospital for an overdose. The data showed 91% of those who survived an overdose continued to receive opioids afterwards.

Most of the prescriptions after the overdose—70%—came from the same provider who wrote them before the overdose. Patients taking high doses of the narcotics experienced double the risk of overdosing again. Study author Dr. Marc LaRochelle tells ScienceDaily:

“It is unclear if the physician who prescribed the medication was notified when their patient experienced an overdose event, which is important to note…As a provider, this is troublesome because this is information that I need access to in order to best treat my patient.”

To change this, the researchers recommended leveraging the power of nationwide programs designed to monitor prescription drug usage. Another option could be to use health insurance records to require prior authorization for overdose survivors before they can receive a new prescription.

3. Chronic pain breakthrough strategy heals the section of the brain damaged by ongoing pain, researchers discover

Chronic pain damages the functioning of a brain region connected to happiness, sadness, and addiction. As a result, the brain essentially gets addicted to pain, or rather, the brain’s chemical processes related to pain.

However a new treatment that combines two separate drugs encourages brain repair while reducing pain symptoms, according to a study published in Nature Neuroscience.

The two medications are a non-steroidal anti-inflammatory drug (NSAID) and a Parkinson’s drug called L-dopa. Together, they work in a special way that eliminated chronic pain behavior in mice. The results were so promising that researchers are now pursuing a clinical trial with humans. Scientists hope this discovery paves the way to prevent the development of chronic pain. Study co-author D. James Surmeier says:

“It was surprising to us that chronic pain actually rewires the part of the brain controlling whether you feel happy or sad…By understanding what was causing these changes, we were able to design a corrective therapy that worked remarkably well in the models.”

The question, he adds, is whether this same combination of pills will work in humans.

4. Doctors need a better understanding of potential for opioid abuse, study says

New research from Johns Hopkins University has found that many primary care physicians, the most frequent source of prescription painkillers, don’t have a true understanding of pills’ risks for abuse and addiction.

For example, doctors surveyed believed those pills formulated to reduce the potential for crushing or snorting were less addictive than traditionally formulated pills. In truth, the potential for addiction is equal in both formulations. Study leader Dr. G. Caleb Alexander tells ScienceDaily:

“If doctors and patients fail to understand this, they may believe opioids are safer than is actually the case and prescribe them more readily than they should.”

Alexander adds that many doctors continue to overestimate the ability of prescription painkillers to reduce pain and underestimate the danger of abuse and addiction. That, he adds, is why the opioid epidemic has become so overwhelming and highlights the work that needs to be done to slow it down.

What study on prescription painkillers did you find the most interesting?

Image by Charles Williams via Flickr

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