Opioids (also known as narcotics), are a category of medications prescribed by Pain Doctors in order to treat patients’ severe or persistent pain. They are given to patients experiencing severe pain linked to cancer; those recovering from surgery or suffering from long-term backaches and headaches; and individuals who have serious injuries [1].
Did You Know?
“Opioids block pain messages sent from the body through the spinal cord to the brain. But while they can effectively relieve pain, opioids carry some risks, and can be highly addictive. The risk of addiction is especially high when opioids are used to manage chronic pain over a long period of time” [1], and this is why Pain Specialists offer a broad range of both conventional and cutting-edge treatments and therapies
When you have a consultation with a Pain Doctor, they will review your medical history, ask you a number of pertinent questions, and arrange for any necessary tests and scans. Then, once they have attained an accurate diagnosis, they will compile a holistic Personalised Treatment Plan, that you can get started on right away.
So What Are the Benefits and Negatives of Using Opioids?
As the Faculty of Pain Medicine at the Royal College of Anaesthetists, notes:
• Opioids serve as excellent analgesics for acute pain and end of life pain; however, there is little research which indicates that they are beneficial for patients with long-term pain
• A small percentage of those prescribed opioids may experience good pain relief in the long-term (as long as the dose kept low); and when consumption is intermittent
• “The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is no increased benefit: tapering or stopping high dose opioids needs careful planning and collaboration” [2]
• When an individual’s pain continues to be severe in spite of their opioid treatment, a Pain Doctor will advise them that the opioids are not working, and that they should cease taking them. The Pain Doctor will then put them on a Personalised Treatment Plan involving multiple types of treatment [2]
The Intricacies of Chronic Pain
Long-term pain is very complex, and if patients suffer from disabling and unresponsive symptoms, (especially if they consume high opioid doses), the Pain Consultant will need to undertake a detailed appraisal of the emotional influences that are being generated by their pain experience [2]
The Myriad of Viable Alternatives to Opioids
These alternatives which are offered by leading Pain Doctors, comprise:
• Dorsal Root Ganglion and Peripheral Nerve Stimulation
• Spinal Cord Stimulation
• Sympathetic Nerve Blocks
• Radio-frequency Ablations
• Epidural Steroid Injections
• Trigger Point Injections
• Peripheral Nerve Blocks
• Joint Injections
• Topical Medications
• Anticonvulsants
• Antidepressants
• Corticosteroids
• NSAIDs
• Transcutaneous Electric Nerve Stimulation (TENS)
• Physiotherapy [patients are referred to an associated physiotherapist specialist by their Pain Doctor]
• Cognitive Behavioural Therapy (CBT). [This is arranged with a referral from the Pain Doctor] [3]
The Low-Down on Peripheral Nerve Blocks
With regard to managing long-term pain: Pain Doctors frequently use peripheral nerve blocks as either a diagnostic or therapeutic agent. “Occipital nerve blocks, intercostal nerve blocks, medial branch nerve blocks, and genicular nerve blocks, are a few commonly performed nerve blocks” [3]. Treatment is very quick, and patients can arrange to visit the Pain Specialist’s office at lunchtime or after work.
References
[1]. American Society of Anesthesiologists (2023). “What Are Opioids?”
https://www.asahq.org/madeforthismoment/pain-management/opioid-treatment/what-are-opioids/
[2]. Faculty of Pain Medicine(2023). “Opioid Beware.”
https://www.fpm.ac.uk/opioids-aware
[3]. Dey S, Vrooman BM. Alternatives to Opioids for Managing Pain. [Updated 2023 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. https://www.ncbi.nlm.nih.gov/books/NBK574543/
