Avoid Addictive Opioids
Opioid medications are prescribed at alarming rates. While there has been a decrease in opioid prescription in recent years, they are still prescribed at disturbing rates. According to the Centers for Disease Control and Prevention (CDC), in 2016 health care providers wrote 214 million prescriptions for opioid pain medication. Sales of prescription opioids have quadrupled in the United States, even though there has not been an overall change in the amount of pain that Americans report.
The risk for misusing prescription opioids is real. According to the CDC, every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.
The risk for addiction is real. CDC reports that as many as 1 in 4 people who receive prescription opioids long-term for noncancer pain in primary care settings struggles with addiction.
The risk for heroin use is real. CDC reports that among new heroin users, about 3 out of 4 report abusing prescription opioids before using heroin.
Doctor-prescribed opioids are appropriate in some cases, but they just mask the pain, and opioid risks include depression, overdose, and addiction, plus withdrawal symptoms when stopping use. That's why the CDC recommends safer alternatives like Physical Therapy to manage pain. In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed. Still, the CDC guidelines also suggest pairing opioid therapy with nonopioid therapy, and their prescriber checklist recommends trying nonopioid therapy first including Physical Therapy.
Patients should choose Physical Therapy when -
- The risks of opioid use outweigh the rewards - Potential side effects of opioids include depression, overdose, and addiction, plus withdrawal symptoms when stopping opioid use. Because of these risks, “experts agreed that opioids should not be considered first line or routine therapy for chronic pain," the CDC guidelines state. Even in cases when evidence on the long-term benefits of non-opioid therapies is limited, "risks are much lower" with non-opioid treatment plans.
- Patients want to do more than mask the pain - Opioids reduce the sensation of pain by interrupting pain signals to the brain. Physical therapists treat pain through movement while partnering with patients to improve or maintain their mobility and quality of life.
- Pain or function problems are related to low back pain, hip or knee osteoarthritis, or fibromyalgia - The CDC cites "high-quality evidence" supporting exercise as part of a Physical Therapy treatment plan for those familiar conditions.
- Opioids are prescribed for pain - Even in situations when opioids are prescribed, the CDC recommends that patients should receive "the lowest effective dosage," and opioids "should be combined" with nonopioid therapies, such as Physical Therapy.
- Pain that lasts 90 days - At this point, the pain is considered "chronic," and the risks for continued opioid use increase. An estimated 116 million Americans have chronic pain each year. The CDC guidelines note that nonopioid therapies are "preferred" for chronic pain and that "clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient."
Patients have a choice about the kind of treatment they receive. Before accepting a prescription for opioids, patients should talk to their health care providers about related risks and safer alternatives. No one wants to live in pain. But no one should put their health at risk in an effort to be pain free. Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for nonopioid treatment. Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids. Physical therapists treat pain through movement, hands-on care, and patient education, and by increasing physical activity you can also reduce your risk of other chronic diseases. Physical Therapy is a safe and effective alternative to opioids for long-term pain management.
When it comes to your health, you have a choice. Choose more movement and better health. Choose Physical Therapy!