Do We Really Need Opioids for Pain?

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Posted on: September 27, 2015

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By Dr. Mercola

The U.S. is in the midst of an opioid crisis, with more than 91 Americans fatally overdosing on the powerful drugs every day.1 The statistic includes prescription opioids, heroin and fentanyl, but many of the deaths stem from prescription drug use. In fact, of the more than 33,000 Americans killed by opioids in 2015, nearly half of them involved a prescription for the drugs.2 Even the U.S. National Institute on Drug Abuse (NIDA) states:3

"In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive."

Fast-forward about two decades later, and it was estimated that, in 2015, 2 million Americans suffered from substance use disorders related to prescription opioid pain relievers.4

The U.S. Centers for Disease Control and Prevention (CDC) also highlights the fact that overdoses from prescription opioids, in particular, "are a driving factor in the 15-year increase in opioid overdose deaths," noting, "The amount of prescription opioids sold to pharmacies, hospitals, and doctors' offices nearly quadrupled from 1999 to 2010, yet there had not been an overall change in the amount of pain that Americans reported."5

Prescription opioids are considered standard care for treating severe pain following surgery or injury or due to illnesses such as cancer, although they're now increasingly prescribed for many types of pain, including chronic back pain or pain from osteoarthritis. Even in the former case, however, research is now questioning whether the dangerous drugs work better than safer options.

Non-Opioid Pain Relievers Work Just as Well to Treat Pain in ER Patients

If a person comes to the emergency room with severe acute pain, most physicians would prescribe them an opioid to relieve pain. Research published in the Journal of the American Medical Association (JAMA) suggests, however, that less risky opioid-free options may work just as well.6

The study evaluated the effects of four different combinations of pain relievers — three with different opioids and one opioid-free option composed of ibuprofen (i.e., Advil) and acetaminophen (i.e., Tylenol) — on people with moderate to severe pain in an extremity, due to bone fractures, shoulder dislocation and other injuries. The patients had an average pain score of 8.7 (on a scale of zero to 10) when they arrived.

Two hours later, after receiving one of the pain-relief combinations, their pain levels decreased similarly, regardless of which drug-combo they received. Specifically, pain scores fell by:7

  • 4.3 in the ibuprofen and acetaminophen group
  • 4.4 in the oxycodone and acetaminophen group
  • 3.5 in the hydrocodone and acetaminophen group
  • 3.9 in the codeine...

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