Amid today’s opioid crisis, it can be difficult for acute and chronic pain patients to get the help they need. Doctors have become wary of patients who ask for too much pain medication, and they are on their guard against “doctor shopping” for patients who want to be prescribed more medication than is necessary for their condition. Dr. J. Fred Stoner, the President of the Lawrence County Medical Society, outlines some of the ways that the medical profession is finding a balance between the needs of pain patients and the stark reality of the opioid epidemic.
Focus on Acute Trauma
In terms of acute illness and injury, opioids can be given to combat the effects of the injury. Patients need to be warned that their pain may not be able to be resolved completely before the opioids will be discontinued. Other forms of pain medication, like NSAIDs and acetaminophen, will be needed to supplement the opioid prescription.
Restricting the number of pills that a patient receives is one of the first steps toward avoiding opioid addiction. The opioid will be available for the first 5 to 7 days following the injury, and then the patient will be tapered off the medication. This will avoid bothersome withdrawal symptoms and make it far less likely that the acute pain patient will become an opioid addict.
Patients need to be encouraged to follow up with their doctors after the injury. Visiting the doctor regularly will allow the doctor to judge how well the treatment plan is working and to prescribe more medication if it is truly needed.
Massage, ice, and heat therapies need to be considered for patients with acute pain. Deep breathing techniques and meditation can also be useful. Combined with these non-drug therapies, opioid medications can be an important supplement.
For patients with enough mobility, yoga can be a helpful technique for releasing muscle tension and improving flexibility. This type of exercise is also beneficial for the mind and spirit, bringing the patient a more balanced view of their situation. It may lower pain medication needs on its own.
Pain and Function
Overall, it is necessary that all pain patients be assessed to see whether they are experiencing a functional improvement as well as a pain improvement. If they are experiencing no pain but are not getting enough movement to be healthy, their recovery will be impaired.
Above all, doctors want to avoid the stereotypical situation of a mobility impaired patient taking too many opioid medications and becoming addicted. It is far better for the patient to encourage regular movement and to work toward regaining function in the injured area.
Chronic Pain Patients
Different protocols need to be put in place for patients with chronic pain issues such as fibromyalgia. These patients are less likely to become addicted to opioids than acute patients whose prescriptions have not been carefully managed. These patients need to be monitored for side effects of opioids. They also need to be aware that others may appropriate their medications for misuse or resale.
Addiction is a Disease
If a pain patient does become addicted to opioids, it is important to remember that addiction is a disease worthy of treatment and sympathy. Patients should receive appropriate addiction treatment. Going “cold turkey” is not recommended. Patients should be encouraged to attend a rehab center or therapy to make sure that any underlying psychiatric problems are addressed.
Pain Can Be Managed
Pain management doctors like Dr. J. Fred Stoner of the Lawrence County Medical Society understand the needs of chronic and acute pain patients. They are highly concerned with helping these patients avoid becoming addicted to their pain medication. Going forward, Dr. Stoner recommends that all doctors study the newest recommendations in the field of pain management.