America is in the midst of an epidemic of pain medication abuse. The problem is the addictive nature of prescription opioids: a recent report from the “Trust for America’s Health” found double- and triple-digit increases in synthetic opioid deaths from 2016–2017 of both males and females, from all ethnicities, and in every region of the nation.
Pain is frustrating and debilitating, and it can take over your life without warning. Unfortunately, opioid-based pain medications can be addictive, which can cause an entirely new set of problems.
It isn’t always simple to manage pain without habit-forming medications, or it wouldn’t be the problem it is … but there are alternatives. It’s best to be forearmed with the knowledge to protect yourself and your loved ones.
Not all Pain Medications are Habit-forming
According to government statistics, more than 47,000 Americans died from opioid overdose in 2017, a figure which includes prescription opioids, heroin, and the synthetic drug, fentanyl. Any medication requires caution, but the abuse factor makes opioids one of the riskiest.
The good news is that there are safe, effective medications which aren’t habit forming—and more are in development. Also, for many types of pain, it’s been shown that opioids are not more effective than non-opioid medications.
The most common non-opioid (non-narcotic) pain relievers are nonsteroidal anti-inflammatory drugs (NSAIDs). These are effective against mild-to-moderate pain from many different conditions, including headaches, fever, inflammation, arthritis, sprains, cramps, muscle soreness, and toothaches. NSAIDs are often available over-the-counter.
Out of the nearly two dozen NSAIDs available by prescription, three are available over-the-counter in the US and most countries:
• Aspirin (Bayer, Bufferin, generics) – the most common NSAID is a synthetic derivative of salicylic acid, a natural compound found in foods. Salicylic have been used for healing and pain relief since ancient times.
• Naproxen (Aleve, generics) – Treats pain, fever, and swelling. Naproxen is similar to ibuprofen and begins working in just 30 minutes.
• Ibuprofen (Advil, Motrin, generics) – This medicine is effective for pain and fever, and can help with swelling—but its effects wear off quickly and must be readministered every 4-6 hours. The increased risk is associated with long-term use of over three months.
This is the world’s most popular pain medication, otherwise known as Tylenol. It relieves pain by blocking the production of prostaglandins in your system that can cause inflammation and fever. If correctly managed, this is a front-line pain treatment.
Acetaminophen is available over-the-counter and is generally well tolerated—though its effectiveness varies according to the pain condition and the individual’s system. Though considered safe, long-term use at higher dosages does carry some risk, and serious drug interactions are possible.
Antidepressants have proven helpful with nerve-associated pain such as with fibromyalgia and diabetic neuropathy. Tricyclics are the most common antidepressant used for pain treatment, even though their action isn’t fully understood. Effects come on slowly over the period of a few weeks, not hours, and they’re not habit-forming.
Other Non-Habit-forming Medications
Other non-addictive pain-relieving medications are targeted to certain conditions or applications. These require a prescription and medical oversight in the US and most countries.
Non-addictive antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs) are typically quite effective against diabetic neuropathy pain. There are several SNRIs currently on the market.
• Duloxetine (Cymbalta)
• Venlafaxine XR (Effexor XR)
• Desvenlafaxine (Pristiq)
• Milnacipran (Savella)
• Levomilnacipran (Fetzima).
Certain anticonvulsant medications seem to relieve pain by affecting calcium and GABA levels in your bloodstream. These manage pain from damaged nerves without risk of addiction.
Two medications, gabapentin, and pregabalin are especially effective in treating shingles-related neuralgia, diabetic neuropathy, and pain from spinal cord injuries. Newer medications have fewer side effects than older medications of this class.
Pain medicine can be applied to the skin instead of being ingested, so there isn’t a risk of addiction.
One common example is the lidocaine patch that is commonly used to treat shingles-related pain. Another is capsaicin ointment, from the active ingredient of chili peppers, which is effective against joint and diabetic nerve pain.
It’s not always evident from the media’s reports about opioid pain-killer addiction, but there’s good news, too. A number of safe and effective non-addictive pain medications are available, and there are promising medicines on the horizon.
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