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Are opiates dangerous for treating chronic pain?

As healthcare providers try to curb the opioid epidemic, doctors are more conservative in prescribing these drugs.

Patients recovering from accidents or surgeries may be given exercise regimens, physical therapy, or less powerful medications. That’s because opioids and their cousins, opiates, are helpful for acute pain, but they are dangerous in managing long-term conditions.

“For chronic pain without anatomic or physiologic cause, the literatures do not support the ongoing use of them,” says Thomas Xu, M.D., a Piedmont physiatrist. Physiatrists are doctors with special training in treating pain and managing movement. 

Building tolerance to opioids

Opiates are drugs derived from the opium plant, and they include well known pain medications like morphine and codeine. The word “opioids” is typically used to describe synthetic drugs, like OxyContin, but the body metabolizes opioids in the same way.

If you’re battling acute pain and under a doctor’s care, using opiates for a short period of time can be beneficial.

“Opiates are appropriate medications when used correctly,” says Dr. Xu.

But once you’ve been taking these drugs for more than about three to six months, your body builds a tolerance to them. That means you’ll need a higher dose of the drug to get the same effect you used to.

“Chronic opiate use can be very dangerous,” Dr. Xu says. Additionally, some people are genetically hardwired to become tolerant faster.

When you need more drugs for the same pain relief, your chances of addiction and risks of experiencing side effects grow. And no matter how long you use them, opiates can’t cure pain altogether.

Safer ways to manage pain

Although opioids can offer temporary relief, they do not address pain’s underlying roots. Dr. Xu recommends that people suffering from chronic pain get properly diagnosed.

Finding out what’s triggering your problems can illuminate solutions for long-term management. Correctly diagnosed causes of pain can be resolved relatively quickly. There’s rarely a quick fix for chronic pain without an obvious underlying cause, Dr. Xu says, but a healthy lifestyle with regular exercise can put you on the right path.

Using opiates to tame pain can ultimately worsen it, because patients who take opiates for a long time may develop central sensitization, says Dr. Xu. That means the nervous system is constantly over-firing, leading to more pain without easy answers.

Instead of using drugs, Dr. Xu recommends these patients focus on positive lifestyle choices to help reset the pain circuit. These can include:

Fighting stigmas

Opioid addiction in the United States is a major problem. Each day, 46 people in the United States die from an overdose of prescription painkillers, according to the Centers for Disease Control and Prevention.

“The biggest thing with the opiate epidemic is there’s a huge stigma surrounding it,” Dr. Xu says. “It precludes people from seeking the care that they need.”

If you or a loved one struggles with these drugs, quitting cold turkey isn’t the answer. Your body may have developed a dependence, so talking to a doctor should be the first step toward recovery.

Even if you don’t currently use these drugs, you may be surprised to find some at home. Medicine cabinets can become repositories for old prescriptions.

April 27 is National Take Back Day, and it’s the perfect time to return old and unused drugs for the safety of you and your family. Find a disposal site near you.

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