Showing posts with label pain relief. Show all posts

Non-Opioid Pain Management to Prevent Painkiller Addiction

non-opioid pain management
Even for those without an addictive disorder, the long-term use of opioids will result in an increased tolerance to them and withdrawal symptoms when coming off of them. This has led many primary care physicians to avoid prescribing opioids for chronic pain and instead refer their patients to pain management programs for treatment. For patients in addiction recovery, it is wise to consider the many alternatives to opioid-based pain management.

Addiction versus Dependence

According to the Journal of American Psychiatry, the word "dependence" was introduced in an effort to combat the stigma associated with the word "addiction," differentiating between patients with psychological cravings for a drug and those with isolated physical dependence. Instead of clarifying, however, this distinction has become confusing for patients. The continued interchangeability of the terms in the media compounds the problem.

The New England Journal of Medicine defines physical dependence as a physiological problem, a problem stemming from the body’s organ systems, and addiction as a psychological problem. While physical dependence is the expected outcome of chronic opioid use and involves the acute onset of withdrawal symptoms when they are stopped, those suffering from addiction exhibit an additional psychological craving for the drug. Addiction involves a pattern of behavior, both drug-seeking and drug-abusing, that is not found in those who are simply physically dependent.


Non-Opioid Pain Treatment Options

Fortunately, opioids are not the only option for pain relief. Additional treatments are available and can be used by themselves or as adjunct therapies to pain medications. Options range from non-opioid analgesics to simple exercises done at home. Used alone or in combination, they give each patient a wide array of options to control their pain.

Physical therapy modalities for pain may include ultrasound, paraffin wax, massage therapy, traction and instruction in specific pain-relieving exercises. Patients may be instructed in biofeedback techniques or receive electroanalgesia from TENS, PENS, or CES. Some therapy locations offer aquatic therapy on site, or instruction on water exercises to do at home. Occupational therapists can offer instruction in ergonomics to prevent poor posture and positioning that leads to pain problems.

Many health insurance companies are now covering the cost of acupuncture and chiropractic office visits to treat pain. Herbal remedies and supplements are not generally covered by insurance, but are an alternative treatment option to consider. Vitamin D supplements have recently been used successfully to treat musculoskeletal pain, and aromatherapy and music therapy have proven successful in some patients.

Psychological interventions for pain include hypnosis and behavior modification techniques. Pain associated with depression or anxiety may be eliminated with an antidepressant or anti-anxiety medication; and Lyrica has recently been introduced specifically for fibromyalgia treatment. Medications for pain include the non-opioid analgesics such as tramadol or Tylenol; muscle relaxants such as Flexeril or Skelaxin; and the topical analgesics like capsaicin. There are a wide variety of medications for specific pain conditions such as migraines, postherpetic neuralgia and peripheral neuropathy. For those seeking arthritis pain relief, it may be as simple as choosing the best NSAIDs for their needs.

If surgical treatment is not an option, interventional therapies such as spinal cord stimulator placement or Botox injections might be considered. Local sympathetic blocks have proven effective for chronic regional pain syndromes, and there are a variety of options available depending on the cause and location of the pain.

With the prevalence of hydrocodone addiction, non-opioid pain treatment options provide both patients and physicians with alternatives to consider. However, if pain cannot be managed with such interventions, opioids are still a safe and effective option when managed correctly. Inadequate pain relief will encourage patients to self-medicate, and a doctor-monitored program that includes opioids is preferable to self-medicating patients. Chronic pain management programs allow patients to explore all the alternatives available, including opioids, while remaining under the management of a single physician.

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Methadone - Uses, Side Effects, and Withdrawal

methadone

Methadone is an opiate narcotic analgesic. Methadone has two main functions. It is prescribed to relieve moderate to severe pain in patients when non-narcotic pain relievers do not achieve adequate results. It is also used to prevent withdrawal symptoms and dependence in patients who are addicted to opiate drugs, such as heroin or morphine.

Methadone for Pain Relief

When used to treat moderate to severe pain, methadone works by changing the way the nervous system and the brain respond to pain. Methadone is considered an opiate (narcotic) analgesic.

Methadone is used every four to 12 hours to relieve pain. The prescribing physician will decided on the correct dosage based on the needs of the individual patient. Dosages may be increased or decreased depending on the level of pain relief achieved.

Methadone should not be stopped without first discussing this with the prescribing doctor. Doctors generally decrease the dosage to avoid any withdrawal symptoms.

Methadone for Treatment of Narcotic Addiction, Withdrawal, and Dependence

Methadone has been used for over 30 years to safely and effectively treat narcotic withdrawal and dependence. Heroin or morphine type drugs release an excess of dopamine in the body and cause users to need heroine or the drug of choice to continuously occupy the opioid receptor in the brain. Methadone works by occupying the opioid receptor and is the stabilizer to allow addicts to change their behavior and stop heroin or other opioid drug use by eliminating withdrawal symptoms.

Methadone suppresses narcotic withdrawal for 24 to 36 hours. It reduces cravings associated with heroin or other opioid drugs and blocks the high and does not provide an euphoric rush. Patients on methadone do not experience extreme highs and lows associated with different heroin levels in the blood stream.

Methadone withdrawal is slower than heroin withdrawal. Addicts on methadone do not experience the harsh side effects of heroin. Many patients require continuous treatment for several years.

Methadone treatment programs are highly regulated by the U.S. Food and Drug Administration. Patients on a methadone treatment program for opioid addiction are required to report to methadone clinics and physician offices to obtain doses of methadone.

Side Effects of Methadone

Methadone can cause a number of side effects. Any of the following side effects, if severe, should be reported to the prescribing physician:
  • weakness
  • headache
  • nausea or vomiting
  • loss of appetite
  • drowsiness
  • weight gain
  • vision problems
  • mood changes
  • difficulty falling asleep or staying asleep
  • swelling of the hands, arms, feet or legs
  • sweating or flushing
  • stomach pain
  • constipation
  • difficulty urinating
  • dry mouth
  • missed menstrual periods
  • decreased sexual ability or desire

Patients need to contact their doctor immediately if they experience any seizures, itching, hives, or have a rash.

Warning Regarding Methadone Usage

Methadone may cause an irregular heartbeat or slowed breathing, both can be life-threatening. Patients should contact their physician immediately if they experience:
  • difficulty breathing
  • extreme drowsiness
  • shallow or slow breathing
  • fast, slow, pounding, or irregular heartbeat
  • severe dizziness
  • faintness
  • confusion

The risk of these side effects is greatest when methadone is first used. Doctors may start a patient on a low dose and gradually increase the dose as the body adjusts to the medication.

Never take more methadone than prescribed. If taking methadone for pain management, pain may return before it is time for the next dose of methadone. Do not take an extra dose. Methadone can build up in the body and cause a life threatening side effect. Talk to the doctor if the pain medication is not lasting long enough between doses.

Considerations Regarding Methadone Use

Methadone is an effective treatment for patients in severe pain. It can be used safely and has shown positive results in opioid addicted patients.

Methadone should be stored in a safe place and never be used by a person that was not prescribed the medication. Keep track of how many tablets or how much solution is left to help determine if any is missing.

Always keep appointments with doctors, clinics, and laboratories. Physicians will need to check on every patient's response to methadone. Methadone is not a refillable prescription. Patients will need to see the doctor each time a prescription is needed.

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