One big challenge with opioid use is its effectiveness against pain, and pain is very real. Long-term treatment relies on pharmacologic therapy and behavioral therapy. The objective of treatment is to reduce the dependence and addiction on opioid drugs and thus to decrease the opioid-related deaths and mortality. Clinical studies show behavioral modification isn’t effective on its own because the body has physical dependence that must be addressed. Opioid abuse is not an ethical or moral addiction, but rather a physiological response to the need for opioid receptor activation.
Physical withdrawal is painful and difficult, and those with opioid addiction will do anything to avoid it. With careful management, a person can successfully overcome the physical withdrawal; however, the psychological withdrawal is often more difficult and requires continual emotional support. Programs such as Alcoholics Anonymous can help guide the person through a series of steps towards independence from opioids, drugs, and pain.
Pain clinics are a newly developed specialty that allows patients suffering from chronic pain to work with a pain specialist for more effective management using a variety of modalities. It is estimated that at least 100 million Americans live with chronic pain. Pain clinics can offer help by focusing on procedures that deal with specific pain (eg, neck, lower back pain). They can also approach pain in an interdisciplinary way involving psychologists, physical therapists, nutritionists, and occupational and vocational therapists, in addition to physicians and nurses. They can suggest other modalities such as acupuncture, biofeedback, cognitive behavioral therapy, water therapy, massage, and meditation as options for chronic pain in lieu of opioids. Both patient education and prescriber need to include these alternative treatment strategies.
Recognition of opioid use within healthcare professionals has been addressed by the National Council of State Boards of Nursing. A free educational webinar for understanding substance use disorder and help in identifying signs of opioid use is available to nurses and managers. The webinar also outlines a system for helping professionals into therapy and recovery. Click here to access the webinar.
Test Your Knowledge
Which of the following is NOT a strategy to help with chronic pain and opioid use?
Apply Your Knowledge
How can you be an advocate to improve pain control without the use of opioids?