Chronic Pain Research

Opioid addiction is so prevalent in the healthcare system because of the countless number of hospital patients being treated for chronic pain. While opioid analgesics have beneficial painkilling properties, they also yield detrimental dependence and addiction. There is a legitimate need for the health care system to provide powerful medications because prolonged pain limits activities of daily living, work productivity, quality of life, etc. (Taylor, 2015). Patients need to receive appropriate pain treatment, however, opioids need to be prescribed after careful consideration of the benefits and risks.

Opioid use in the US has increased over the years, and this has led to an increase in substance abuse. Substance abuse is not only associated with use of illicit drugs but also prescription drugs. In 2015, of the 20.5 million reported cases of substance abuse, 2 million had an abuse disorder related to prescription pain relievers and 591,000 associated with heroin.1 The increase in substance abuse disorder has led to an increase in opioid related death. In 2015 drug overdose was the leading cause of accidental death in the US with 52, 404 lethal drug overdoses.2

Last year there were over 64,000 reported opioid-related deaths in the United States – making it the leading cause of accidental death in people under the age of 50 in this country (Katz). Opioids, also referred to as painkillers, have become a growing problem over the past two decades particularly in rural communities all across the country where the death rates are higher per capita compared to the death rate in cities (“America’s Opioid Epidemic is Worsening”). These narcotics, such as codeine, fentanyl, hydrocodone, morphine and oxycodone are extremely addictive and, as a result, this silent killer has quadrupled the overdose death toll since 1999

While our major access to these drugs is doctors, we cannot simply lay blame on them, as there is not enough knowledge about these treatments to correctly appropriate drugs, and therefore extra is given (Hemphill 373). Alexander of the Department of Epidemiology of the Journal of the American Medical Association, states that “There are serious gaps in the knowledge base regarding opioid use for other chronic nonmalignant pain” (Alexander 1865-1866), which leads to the unfortunately large number of leftover drugs. In fact, the main place that people get their drugs are from leftover prescriptions (Hemphill 373).

The United States currently faces an unprecedented epidemic of opioid addiction. This includes painkillers, heroin, and other drugs made from the same base chemical. In the couple of years, approximately one out of twenty Americans reported misuse or abuse of prescriptions painkillers. Heroin abuse and overdoses are on the rise and are the leading cause of injury deaths, surpassing car accidents and gun shots. The current problem differs from the opioid addiction outbreaks of the past in that it is also predominant in the middle and affluent classes. Ultimately, anyone can be fighting a battle with addiction and it is important for family members and loved ones to know the signs. The cause for this epidemic is that the current spike of opioid abuse can be traced to two decades of increased prescription rates for painkillers by well-meaning physicians.

Addressing the people exposed to opioids may reduce the number of people starting and continuing to abuse drugs in the long term. In addition to this suggestion, data found from 2006-2015, the duration of opioids increased by a third suggesting fewer patients choose to start using opioids for pain management, however, patients already on medication continue to do so. This is because once long term opioid users, even when taking their medication as directed by their doctor, eventually develop a tolerance to the drug. A tolerance to pain medication can cause patients to up their dose or take too many medications in a small time frame in order to alleviate the same amount of pain that a smaller dose would have fixed in the past. The risk of developing tolerance is an important conversation to have with a health care professional because in addiction to pain, patients go on to develop a physical dependence to the drug. Physically patients feel pain, illness, and other symptoms; in some cases they are unable to give up the drug. This is when their dependence is classified as an

According to the guidelines, there are three important principles to follow for the improvement of patient safety and care. Non-Opioid therapy is suggested if patients are non cancer chronic pain patients or in hospice care. Additionally, if opioids are needed, the lowest dose possible for the shortest amount of time is recommended to reduce risk of opioid overdose. Lastly, clinicians must monitor all patients carefully when they prescribe them opioid analgesics. Prescription opioid use is not solely the responsibility of the health care providers. There are a few guidelines patients should follow regarding chronic pain to ensure their safety. Patients should become informed about prescription opioids and learn the risk factors involved. Before going to the doctor about pain, they should consider physical activity, non opioid medications, or cognitive behavioral therapy before automatically thinking they are in need of painkillers (CDC Guideline for Prescribing Opioids). Continuing education (CE) is another regulation. While Continued Medical Education (CME) is required in most states in the U.S. for physicians every ten years, there should be a continuing pain medicine education requirement for all physicians due to the heavy increase in prescription

The opioid crisis has been gradually increasing since the discovery of opioids as pain management medication by pain specialists in the 1980s. If the crisis is not mitigated, more people are likely to suffer the consequence of the effects of addiction and overdosage, given the highly addictive nature of opioids. Mitigating the crisis requires collaborative efforts, particularly from clinical prescribers and drug manufacturers who need to recognize that these drugs are potentially harmful when used repeatedly and misused. Physical therapy is an alternative mitigation measure in handling chronic pain. Evidence shows significant success rates among patients who have chosen the physical therapy route as opposed to the opioid

It has become standard practice for physicians and other prescribers to write a months’ worth of opioid medication for minor, short-term pain conditions. Just two decades ago, opiates were viewed by the medical community as dangerous, addictive and were limited to use only for patients with acute trauma, for end-of-life care, and in cases of cancer pain. Current prescribing practices provide an excess of prescriptions annually, enough for every man and women in the U.S. to have a bottle of opiates (ASAM, 2016). The same formal oath that practitioners pledge to “First, to do no harm,” also advocates that regardless of the treatment focus on disease or ailment, above all, it is a human life that requires sympathy and care. The risks and adverse

Although addiction and overdose of opioids was not declared an epidemic by the Center for Disease Control and Prevention (CDC) until 2011, the beginning of the epidemic can be traced back as early as the 1980’s when attention in medical care began to turn toward pain management. By the early 2000’s the Joint Commission on Accreditation of Healthcare Organizations named pain “the fifth vital sign,” implying that pain is as important clinically as pulse rate, temperature, respiration rate, and blood pressure (Wilson, 2016). At the same time, there has been an emphasis change from patient wellness to patient satisfaction metrics. Non-steroidal anti-inflammatory drugs such as Advil, Aleve, or aspirin have raised safety their own safety concerns, contributing to increased use of opioids. The lack of patient access to and insurance coverage for chronic pain management specialists or alternative healing therapies also contributes to the opioid epidemic (Hawk,

Mandated limits on opioid prescriptions for acute pain offers the promise of advancing the safe use of these medications in two ways. First, it will reduce the exposure of first time users to these addictive substances following episodes of acute pain. For some patients who come to misuse opioids, the euphoria or sedating effects of these medications are initially experienced in the context of routine medical care. There are countless anecdotes of patients who take opioids for a minor orthopedic injury or some other acute pain condition and then go on to use prescription opioids non-medically. A recent population-based study suggested that 6% of incident opioid users progress to long-term use.4 Another study found that patients who received opioids following minor surgery were 44% more likely to become long-term opioid users compared to those who did not.5 Decreasing the initial amount dispensed may potentially lessen the risk that patients develop an affinity for these drugs and transition to chronic use or misuse.

Chronic pain is a huge issue for many people. A lot of people with chronic pain become depressed because they can’t move or do simple tasks without being in a great amount of pain. Chronic pain can be caused by osteoarthritis, fibromyalgia, chronic headaches, rheumatoid arthritis, and neuropathic pain, which is caused by injury to tissues or nerves. Physical therapy helps chronic pain patients become stronger, so they’re able to move better. Physical therapy can also teach people how to move safely and function better than they used to with chronic pain. Exercise can involve walking on a treadmill or swimming in a pool.

Chronic Pain is an interesting problem in society today. The exact cause of Chronic Pain is not the same in every patient. In fact most patients present with different symptoms and associated pathologies, such as the strong link with depression. Treatment of Chronic Pain is often performed a single practitioner whether that be a Medical Doctor, Chiropractor, Nutritionist, or an alternative health care professional. Chronic Pain is often extremely complex, because of this treatment needs to be multidimensional. Effective care of Chronic Pain requires the collective cooperation of health care professionals

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.

This paper is going to talk about how to deal with chronic pain. First of all, this paper will explain what chronic pain means by providing the foremost chronic pain encountered in life such as low back, joints, or other kinds. Next, this paper will cover why it is important to address conditions related to chronic pain, and will explore methods and strategies showing how to cope with continuing pain. Finally, this paper will share some predictable outcomes and a conclusion.