The ongoing opioid crisis and understanding pain

There is an opioid crisis in this country when prescription opioid deaths have more than quadrupled since 1999. According to the Center for Disease Control in Atlanta, Georgia, “1 in 4 people who receive prescriptions for non-cancer pain in primary care settings struggle with addiction.” What began this epidemic? In the 1990s, drug companies were lobbying government agencies and physician groups to consider as a vital sign of a patient’s health assessment “pain levels” as low as ”4 out of 10” to require necessary medication. 

Why is this drug crisis considered an epidemic today? Dr. Phil Page, editor-in-chief of Journal of Performance Health, Hands on Science, Vol. 2, #2, Winter, 2017, states “Make no mistake. This is an epidemic because it touches so many people: Those…who become addicted, those who turn to illegal drugs when prescription pills are not available, and those who die from an overdose.” He admonishes us to not forget the families involved in this tragedy, as well.   

The saddest part of this situation is that patients with unbearable pain (such as cancer patients) have no recourse but to take opioids. In some cases because of this drug crisis, it has become more difficult for these individuals to get the necessary opioids they require to avoid the possible tendency of pain-escaping suicide. As a result, many physicians find themselves now struggling to find safe and effective relievers for their patients with chronic pain. Dr. Page adds, “And don’t forget: even non-opioid pain relievers like NSAIDS (over-the-counter drugs such as aspirin, ibuprofen, and naproxen) can have serious side effects like gastric bleeding and cardiac events.”

Page calls out for help from the community of physical therapists, occupational therapists, chiropractors, massage therapists, and athletic trainers. He asks them “to position themselves as non-prescription pain relievers through interventions like exercise, the physical treatment of an ailment, and manual therapies, as well as (most importantly) pain education.” Page states that, unfortunately, pain research is still emerging. 

Here are 5 important points in helping to understand how pain works: 

1. Pain is individualized and works off of physical, psychological, and emotional differences unique to each individual. 

2. Many ineffective treatments are given due to an inability of science and medicine to understand a patient’s pain. 

3. Pain serves a real purpose when it becomes a warning sign to avoid a certain behavior. 

4. How a person perceives the pain signal in his/her brain can depend on the input of a variety of receptors such as temperature and pressure. 

5. Pain may lead to “fear-avoidance” behavior, when people refuse to move thinking more pain (or something equally as bad) might result. Instead movement is often the best medicine.  

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