Are Opioids the Most Effective Treatment for Pain?

Opioid pain relievers are commonly prescribed to patients struggling with chronic pain, as well as those undergoing surgery or healing from an injury.  Opioids have been around a long time, but the vast cultural acceptance of these pain relievers, alongside the tendency to prescribe them over other alternatives, has led to a crisis.  Opioids are extremely addictive, and many patients begin taking them without a realistic understanding of their potential for abuse. For those that become addicted, maintaining access to opioids can take precedence over personal responsibilities and health.  Opioid addiction leads to a wide array of physical and mental health issues, and treatment usually requires professional intervention.

For people struggling with opioid addiction due to an attempt at pain management, the thought of giving up the drugs can be terrifying.  Not only is the pain of withdrawal a major concern, but many people believe they will not be able to alleviate their pain without opioid pain relievers.  Recent studies, however, suggest that opioids may not be as effective at managing pain as originally believed, and the data indicates the risks of opioid use far outweigh the benefits.  By understanding the realistic efficacy of opioid pain relievers, as well as the efficacy of alternative pain medications, people struggling with addiction and chronic pain can eliminate much of their fear of becoming sober.   

What Are Opioids?

Although talk of the opioid crisis is a recent phenomenon, opioid use and the many resulting problems have been around for thousands of years.  Opioids are derived from opium, which is extracted from the poppy plant. Drugs derived from this plant have had a monumental impact on human history, playing a role in major wars and destroying many lives.  Heroin, known to be one of the most addictive illegal street drugs, is closely related to the opioid pain relievers commonly prescribed by medical professionals. These drugs include oxycodone (known by the brand name OxyContin), hydrocodone (also known as Vicodin), codeine, and morphine.  These drugs are often sold on the street to people who have developed an addiction after being prescribed one of these medications for pain. Developing an addiction to prescription opioids greatly increases the risk of heroin addiction, as many users encounter difficulty refilling their prescriptions as well as a tolerance developing that requires increasingly potent versions of the drug. 

The Evidence

A recent review of several studies regarding the efficacy of opioid pain relief found that opioid pain medications are far less effective than most people believe.  The success of medication is measured by the medication’s ability to produce a 50% decrease in the pain of the patient, therefore significantly improving the quality of life.  A review conducted by The Cochrane Collaboration found that in the case of oxycodone, 46 people would need to be treated with the medication to produce 10 patients with at least 50% pain relief.  When oxycodone is combined with acetaminophen, as is the case with the medication Percocet, the results are a bit better, with only 27 people needing to be treated to see 50% pain relief in 10 of those patients.  Either way, these numbers don’t represent what we would expect to see with medications most people consider the most powerful and effective option available. 

Alternatives

Many of the studies that have looked at the pain-relieving results of opioid pain medications have done so by comparing them to other options.  In the study mentioned above, the combination of acetaminophen and ibuprofen produced the best results, with only 16 patients needing to be treated for 10 of these patients to see at least 50% pain relief.  Both acetaminophen and ibuprofen are over-the-counter drugs. Ibuprofen is a medication in the NSAID category that is not addictive or habit-forming, and acetaminophen, also known as Tylenol, is similarly low risk when it comes to the potential for addiction.  

A review of studies conducted regarding different types of pain and the efficacy of various medications has also concluded that opioids are surprisingly ineffective.  Dental pain appears to respond better to an ibuprofen and acetaminophen combination, as do several kinds of back pain. Furthermore, in a study looking at patients who received opioids early on for spinal disc herniation, patients were found to have a higher rate of back surgery and an increased risk of opioid dependence in four years.  For those suffering from chronic pain, it is important to note that several studies have found no significant benefit to long-term opioid use. While it appears chronic pain sufferers may experience some relief from opioids in the first few months of taking these medications, the pain relief does not last, and many risks tend to follow.

If you or someone you love is struggling with addiction to opioid pain medications, a quality treatment program can provide you with strategies for maintaining long-term sobriety.  At Renewal Lodge by Burning Tree, you will find a team of compassionate, knowledgeable professionals ready to coach each client through the 12-Steps and beyond. By structuring treatment to fit individual needs, including the identification of co-occurring disorders, Burning Tree facilitates an environment of healing and holistic wellness.  Here, our clients tackle their addictions head-on and harness the power to restructure their lives through high accountability and life skills that foster lasting sobriety. We specialize in treatment for the chronic relapser and believe that with the right tools, you can put an end to the cycle of addiction. For more information on how we can help, call us now at 512-285-5900.