Chronic Pain Management: Opioids and Their Alternatives Essay

Opioids are a class of drugs used to help an individual’s pain perception. They include prescriptive and nonprescriptive medications: morphine, oxycodone, hydrocodone, codeine, and fentanyl. Heroin is also an opioid, but it is a classified Schedule 1 illegal drug.

Massage therapy and chiropractic therapy are the most widely CAMs in the United states. Spinal manipulation involves the cyclical movement of a joint, while a massage involves the rhythmic compression of sights of tense bands of skeletal muscle fibers. Both methods are thought to induce a relaxation response - lower blood pressure and heart rate, decreased oxygen consumption and muscle tension, and lower levels of cortisol and noradrenaline, which is ultimately attributed to its beneficial effect.

Philippe Lucas’s article “Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain” recommends using cannabis instead of opiates to relieve chronic pain. He also proposes cannabis may be used to treat prescription opiate abuse by patients suffering from chronic pain and depicts cannabis as a medicine and not a gateway drug. Lucas suggests national governments abandon misinformation emphasizing drug prohibition and start supporting the claim that cannabis effectively treats a variety of illnesses including chronic pain, and is a possible “drug exit” for problematic substance abuse. Appeals to logos, ethos, and pathos are frequently present, creating the ideal balance of evidence and theory regarding medicinal cannabis and opiates.

Until October 2014, it was illegal to dispose of opioids except to flush them down the toilet or transport them to a law enforcement agency. The DEA now allows disposal of unused or expired controlled substances at pharmacies and hospitals with special containers for safely storing the drugs. You can find these locations at http://www.DisposeMyMeds.org.

"If we could sniff or swallow something that would, for five or six hours each day, abolish our solitude as individuals, atone us with our fellows in a glowing exaltation of affection and make life in all its aspects seem not only worth living, but divinely beautiful and significant, and if this heavenly, world-transfiguring drug were of such a kind that we could wake up next morning with a clear head and an undamaged constitution - then, it seems to me, all our problems (and not merely the one small problem of discovering a novel pleasure) would be wholly solved and earth would become paradise."

Acupuncture is an ancient Chinese practice, in which tiny filament needles are inserted at strategic points of the body to treat conditions ranging from headaches and neck pain to fibromyalgia. The needles provoke the release of endorphins and other hormones in the body; promoting enhanced circulation and a noticeable reduction in pain and inflammation.

Opioids are a class of drugs that are designed to relieve pain. They are synthetic forms of the naturally occurring opiate opium along with morphine and codeine, which are parts of the opium poppy. Prescription opioids include the painkillers hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), fentanyl (Duragesic), meperidine (Demerol), and hydromorphone (Dilaudid), amongst others. Opioids of this variety are prescribed for a variety of reasons ranging from severe acute pain resulting from injury to post surgery pain relief. Illicit opioids include heroin and any opioids that are not taken are prescribed. While helpful in treating pain that needs immediate attention, prescription opioids are not ideal to treat chronic pain. Opioids, both prescribed and illicit, are highly addictive and potentially dangerous.

Opioids are a type of pain medication prescribed in pill form, with the most commonly used opioid medications being OxyContin and Vicodin (Gholipour).

Opioids can be divided into three categories: Opiates, Semi-Synthetic Opioids, and Synthetic Opioids. Opiates are derived directly from opium poppies. They include drugs such as Morphine and Codeine. Semi-Synthetic Opioids are derived from Opiates. They include many prescription painkillers such as Hydrocodone, Hydromorphone, Oxycodone, and Oxymorphone. However, this category also includes the illegal street drug Heroin. The third category is Synthetic Opioids, which are not derived from opiates and include drugs such as Fentanyl, Buprenorphine, and Methadone.

Opioids are classified as opium like compounds; some (ex. codeine and morphine) exist naturally in opium, which is a gummy substance derived from the seedpod of the opium poppy, indigenous to Southern Asia. Other opioids are of the synthetic category, such as methadone or fentanyl (opioidaddictionsource.com). Though the use of prescription opioids may be well intended, due to their effect on the brain chemistry, it is fairly common for one to become addicted to them; America is amidst a raging prescription opioid epidemic, in fact.

In this discussion, I will be looking at the different forms of pain and how this pain is caused within the body. The number of different types of drugs used to treat pain is forever expanding but I will examine the main types of painkiller, how they were discovered and how they work to relieve the symptoms of pain.

The term Opioid is derived from the opium poppy. It is an annual herb that contains about eight capsules with different color flowers. The seeds are cut out from the stem and used for different purposes. Descriptions from the Egyptians shows the opium seeds to be used to prevent excessive crying while the Greeks used it for a sleep inducing substance. (Khademi, 2015, p.870) Opium is the starting material for an array of medications. It is synthesized and then is an opioid used for mainly the treatment of pain in anesthesia, cancer, acute pain, osteoarthritis, limb pain, sickle cell anemia, and more. (Khademi, 2015, p870)

Acupuncture is an ancient form of Chinese healing. It has been in use for thousands of years. The practice is now popular in the United States and other western nations, but is considered alternative medicine. The main goal of acupuncture is to increase chi or life force energy within the body. Although the body is self-healing, the theory behind acupuncture is that if the body becomes overloaded with toxins or becomes stagnant, disease and illness develop. Acupuncture stimulates the pathways of the body and encourages energy to flow. This promotes healing.

Massage therapy can help with alleviating muscle tension, diminishing stress, and bringing to mind feelings of calmness, along with helping chronic fatigue syndrome, easing chronic constipation, and enhancing self image. It also manipulates the activity of the musculoskeletal, circulatory, lymphatic, and nervous systems in the body. Clinical studies have revealed that massage relieves chronic back pain more effectively than other treatments and most times it is more cost effective than other treatments ("University of Maryland Medical Center").

Chronic pain is defined as a pain that doesn’t go away for a long time. The pain can last for weeks, more than 3 months, years, and might make someone feel hopeless. Chronic pain does not relief with regular pain medication. It is important to address chronic pain because is physically and psychologically stressful. Its persistent discomfort can lead to irritation and frustration with the person’s self and with other people. Pain affects not only mental health but interfere also with someone’s sleep pattern.