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Author Archive: aenriquez

Hashish addiction

Hashish is a plant derivative substance, extracted from the trichomes, flowers, and fragments of leaves and stems of the cannabis plant. It contains tetrahydrocannabinol (THC), which is the same active ingredients found in marijuana, but at a much higher concentration (up to 15% in hashish as compared to 5% in marijuana). Hash oil is another substance produced by solvent extraction of hashish/marijuana and ends up having even a higher dose of THC.

Based on the way it is prepared, it comes in various forms and preparations. Hash oil comes as a golden syrupy-like substance. Hash is typically consumed by smoking or ingestion, but the effects are much faster and stronger when smoked due to faster entry into the bloodstream through the lungs. How does hashish work? The active substance of hashish, THC acts by binding to cannabinoid receptors in the neurons, which results in physical, emotional, and cognitive effects.

The active substance of hashish, THC acts by binding to cannabinoid receptors in the neurons, which results in physical, emotional, and cognitive effects
While many studies have shown that there are medicinal effects of cannabis products, particularly a substance known as cannabidiol, it should be noted that the United States Drug Enforcement Administration (DEA) still considers cannabis a Schedule I controlled substance, meaning that it is considered to have no medicinal use and a high potential for abuse.

So what does hash abuse look like? Hashish is typically smoked in pipes or bongs. Some users add hashish to food or brew it in a tea, and other casual ways. However, given the potent concentration of THC present in hashish, it has a higher potential for addiction and more serious side effects as compared to marijuana. The typical signs and symptoms of hash addiction include euphoria, increased relaxation, hunger, sore throat, panic, paranoia, anxiety, tachycardia, hypertension, impaired coordination, lack of motivation, impaired concentration, and hallucinations.

Long-term effects of hash abuse include immunosuppression, respiratory issues from chronic lung damage, sexual dysfunction in males, cardiovascular issues, mental issues, etc. As expected, hashish users face significant social issues as well, such as job loss, financial issues, legal issues, strained relationships with spouses, children, and other loved ones, just to name a few.

The use of hashish among teens is disproportionately high. There are several reasons for that – most of them having to do that mainstream acceptance and legalization (in some states) of marijuana, and coupling hashish with it as a comparable alternative, which of course, it isn’t. There is a tendency is downplay the potential for abuse, physical dependence, and other harmful effects of hashish. The teens are even more susceptible to its deleterious effects because of their greater propensity for the development of a substance use disorder. They are also more susceptible to peer pressure and having an underlying ADHD or conduct disorder which increases their predilection for hashish addiction, further leading to polysubstance abuse.

Health awareness and education play an important role in helping teenagers understand the hazards of hashish use. Preventing hashish addiction can also prevent falling prey to other even more serious drugs such as heroin and cocaine.

The Addiction of Sniffing Glue

Sniffing glue is a dangerous addiction. Glue is easily available and provides a degree of euphoria (feeling high) that gets people, especially younger individuals (teenagers) hooked. Solvent glue is categorized as an Inhalant, among others including aerosol sprays, cleaners, etc. There are various forms of solvent glues available, such as model glue and rubber cement.

While it might appear to be a casual activity, it can actually be life-threatening. But even if the result isn’t fatal, it can still lead to brain damage and serious lung injury. The degree of bodily harm this addictive behavior inflicts depends on the type of glue used and the frequency and amount of it inhaled. Some of the symptoms that can help identify someone who is sniffing glue include the chemical odor on clothes and breath, rash around the mouth, headaches, dizziness, nausea and vomiting, mood swings and belligerence, decline in thinking skills, concentration, and decision-making ability, loss of interest in normal activities, lack of interest in personal relationships, numbness and tingling in hands and feet, loss of coordination, fatigue, hearing loss, apathy, impaired judgment, and loss of consciousness.

Inhalants have been known to cause various degrees of brain damage
Some of the most significant organ damage that can result from sniffing glue include:

Lung injury: Sniffing glue can lead to acute respiratory failure, which is a potentially fatal condition. It occurs by direct damage to lung tissue by the chemicals in the glue, which then limits the necessary amount of oxygen being absorbed into the blood. If other substances are being used as well, they can further promote lung damage in these users, and lead to irreversible chronic respiratory failure.

Brain damage: Inhalants have been known to cause various degrees of brain damage. The most widely implicated chemicals are toluene and naphthalene, which can damage the myelin sheath, and cause potentially severe and irreversible damage to brain function.

Cardiac injury: Sniffing inhalants can also cause damage to the heart, specifically its electric circuitry. This can lead to an irregular heartbeat, also known as arrhythmia, and can potentially lead to heart failure. There is a condition known as sudden sniffing death syndrome (SSDS), which may occur even after a single use of an inhalant.

In addition to the above, inhalant use can also cause liver and renal damage.

The treatment for inhalant use is emergent. If the user is found to be unconscious, call 911 immediately and remove them from the toxic environment they were found in. The focus of the emergent treatment is to get the person to be stable, followed by rehab therapy. Rehab therapy is focused on identifying factors that led to the use of inhalants, and help address any underlying causes, such as mental health disorders. While the acute rehab treatment is inpatient, the patient is switched to an outpatient setting once stable enough. It should be followed by relapse prevention programs and support groups to help the recovered patient stay away from the conditions that lead to inhalant use through continued support.

Celebrity Addicts

Are celebrities more prone to addictions than the rest of us mortal human beings who must survive everyday stressors like paying our bills and getting that stain out of the carpet? This is a fair question. And we don’t have an exact answer for you.

But one author-therapist spoke up on the topic, stating clearly that celebrity life includes enormous pressures that most people never experience. Yes, we mortals have severe stress points in our lives. And, yes, the frequent lists on occupations and addictions often names doctors, miners, policemen as very vulnerable to alcoholism and drug abuse. Other lists name forest management, farming, fishermen and sales jobs as high on the list of vulnerable occupations. Seldom do you see celebrities on these lists.

But think of the pressure to be a movie actor, especially one who is the star of the show. If the movie bombs, seldom do the newspapers announce the writer’s career is imperiled. But they frequently write, “if the actor doesn’t find a moneymaker soon to put on his or her resume, their career is cooked.”

 

actors are doubly vulnerable simply because they are sensitive, creative and put their creativity out there for the entire world to see

What’s the problem here? Stress is in the eye of the beholder to a certain degree. If you like chaos, then chaos is not so stressful for you. And, where does this leave doctors? If they make a mistake, the results could be life-changing – devastating. Tell me an actor has more stress than that?

Los Angeles-based Dr. Jenn Mann, an author of a book on relationships, says that actors are doubly vulnerable simply because they are sensitive, creative and put their creativity out there for the entire world to see. In addition, companies invest millions, often hundreds of millions of dollars, in that actor or actress, which puts a lot of heavy expectations on the thespian’s shoulders.

Big Time Pressure

“You take that sort of personality that is already vulnerable to these issues and then you put them in a situation where there is enormous pressure to perform,” Hollywood Life quoted Dr. Mann as saying. “That is unbelievable pressure that very few people can even comprehend in the regular world, because a lot of people go, ‘oh, you’re just getting paid so much money, who cares?” But this is also putting yourself out there and your work and your future,” she said.

What about Money?

Ah, remember money? That’s supposed to be the root of all evil and sometimes it certainly is. What do you do if you’re having an anxiety attack because you have to perform at work the next day – as a doctor, an actor or a businessperson? You might have a drink to calm your nerves. This can become a habit with anyone who lets the alcohol begin to take control. There may be genetic factors involved. You don’t need too much of a push before alcoholism can be diagnosed.

The actor that sparked the interview in Hollywood Life was unknown to me and his name is irrelevant, but he was one of the lead actors to a mega-huge television show. The interesting points of his case included his descriptions in previous interviews about how the months when his character was getting tons and tons of media attention were his worse moments on the show.

Wait — don’t actors live for that kind of attention? Well, yes and no. It’s a double-edged sword. The attention means you will be eligible for a part in another high paying show. But it also means your every move is subjected to public scrutiny, both on the screen and off.

Opportunity

Meanwhile, all that money not only represents pressure but an opportunity. Everyone wants to be your best pal, be part of your life, buy you a drink or have you buy them one … money, money, money. When your paycheck has six zeroes on it, temptations are affordable. Do you want to take the edge off? Six zeroes can certainly make that happen.

In fact, as Dr. Mann said, when you reach “a certain level of stardom,” you suddenly become surrounded by handlers, people who want your attention, your signature, your time, your endorsement. Life begins to swirl and drugs and alcohol can certainly make that swirling go away for a while before the swirling becomes spiraling out of control.

Make A Call

Are you or someone you love suffering from addiction issues? If so, professional help is a phone call away. Call Pacific Bay Recovery in San Diego at 858-263-9700. Call soon and break the cycle.

What is Social Detox?

Social detoxification is a non-medical type of detox program and involves the individual stopping the use of the drugs entirely while under the care of treatment professionals. While being a social method, it involves professionals providing the patient with emotional and psychological support throughout the withdrawal process without any therapeutic intervention.

This method has shown some degree of success but it’s not without its challenges. There remains a significant potential for a withdrawal syndrome and given the lack of a proper setting, may be difficult to manage. The spectrum of withdrawal symptoms varies depending on the specific drug and can be severe and potentially life-threatening. Furthermore, there is a chance that a user who is going through detox in this method may relapse in an effort to relieve their symptoms and cravings for the drug. What’s worse yet is that these individuals have a propensity to overdose when relapsing, making it an even more critical situation.

These management programs can handle serious conditions such as seizures, which is a withdrawal symptom for a number of commonly abused substances
Another aspect of substance use disorder recovery management to keep in mind is that significantly long period of abstinence leads to a marked decrease in the patient’s tolerance level, which can be extremely dangerous as it predisposes to inadvertent potentially lethal overdosing.

Social detox approaches are also poorly equipped to address potential development of psychological issues over the course of withdrawal. These include mental health issues such as depression, suicidal ideation or attempts, anxiety, delirium, and insomnia. Apart from psychological issues, medical complications may also arise during withdrawal. Therefore, it is not advised to perform social detox for the management of withdrawal from alcohol, benzodiazepines, barbiturates, or opioids.

Conversely, these patients need to properly diagnosed and a personalized detox and recovery program needs to be designed keeping their personal, medical and social needs in mind. Medical detox provides patients with a structured environment, proper medication and full ancillary support to address all aspects of substance use disorder recovery. These management programs can handle serious conditions such as seizures, which is a withdrawal symptom for a number of commonly abused substances. Furthermore, if the patient were to become delirious you are able to provide optimal care right away. Confused, agitated states can lead to accidents, erratic behavior, and possibly violence. Being unsupervised in social settings while in that condition is dangerous.

In many of these settings, pharmacologic intervention is necessary, whether it is for the pain, other symptoms or for choosing a drug of lesser strength to avoid a dangerous withdrawal syndrome. This is true for heroin addiction for which methadone is used. Methadone is a full opioid agonist that attaches to and activates opioid receptors in the brain, which decreases cravings and reduces unpleasant withdrawal symptoms. This requires careful monitoring and assessment on a regular basis and can only be dispensed by opioid treatment programs (OTPs). Buprenorphine is another such example where a partial opioid agonist is given to produce a less pronounced opioid effect than a full agonist, such as methadone. Suboxone is a formula containing a combination of buprenorphine and naloxone, a medication that blocks opioid effects.

Using these therapeutic options can be necessary for the right patient given his/her situation and administering these drugs requires a controlled environment and supervision by experienced staff, none of which a social detox method provides.

Methods of Drug Detox

There are various types of drug detox programs depending upon the drug or substance of use. These methods can be very effective if chosen for the right condition. In addition to the type of the drug of abuse, other factors that play a role include the dose taken at the time the patient starts detox, the duration of addiction, and if there is polysubstance abuse determine the most appropriate type of detox. Some of the detox methods include “Cold-Turkey” detox, short-term medicated detox, long-term medicated detox, etc.

The “cold turkey” detox method entails stopping the use of all drugs with no pharmacologic assistance and with only medical care available for emergency situations. These patients experience the full brunt of the withdrawal symptoms with no help from supportive therapy. That makes it a feasible option for less intense addictions but for the rest, the cold turkey detox is not suitable and can be counterproductive, in fact dangerous.

It is important to make sure that first of all, the diagnosis is correctly made, and underlying medical conditions are addressed
Medical detox, on the other hand, is different because patients who opt for medical detox stop taking their substance of use but as they experience withdrawal symptoms, they are able to take certain medications for a limited period of time to ease discomfort. This is why this program is better tolerated and can handle slightly more intense forms of addictions. It is important to note that the medications administered/prescribed in this program are primarily for symptomatic relief, such as non-addictive sleep medication for insomnia or anxiety. The main idea is to minimize the degree of discomfort as these patients are detoxing.

If an alcoholic is undergoing medical detox, they are commonly given benzodiazepines to alleviate anxiety, jitteriness, insomnia, and to treat or prevent seizures, and they have a cross-tolerance with alcohol. However, in order to treat the use of opioid drugs such as heroin and prescription opioids, these medications have to be taken longer-term, especially partial agonists, such as methadone or the drug combination buprenorphine and naloxone (Suboxone). But over time, as the detox continues, they’ll often require lower doses of medication until they’re eventually drug-free.

It is important to make sure that first of all, the diagnosis is correctly made, and underlying medical conditions are addressed, then the right type of detox program is chosen. Regardless of the type of detox program chosen, it has to be done under the supervision of a medical professional.

Both these detox types can be carried out with the patient being at home, but it may not be the best option. The reasons for that are that it may not be entirely safe, given the risk of severe withdrawal symptoms or relapse with an overdose. It is also less effective given the higher chance of noncompliance. Overall, professional detox is safer, better tolerated and more effective in the end. Choosing the right professional detox is key, however. And at Pacificbayrecovery.com, we provide highly professional, evidence-based care to these patients.

Drug Detox for Women

While it is true that men in the United States report higher rates of drug abuse (7.7% of American men vs. 5% of American women), substance use disorder is a significant problem for women as well. A woman goes to the emergency room after abusing prescription painkillers every 3 minutes in the USA. There are approximately 15.8 million adult women per year reported to be using illicit drugs. The most commonly used substance is alcohol (33.3%), followed by heroin (15.3%), marijuana (14.6%), prescription painkillers (13.8%), cocaine (9.3%), methamphetamine/amphetamines (8.6%), etc.

Women have a different clinical presentation of their substance use disorder. They tend to have a shorter history of abusing alcohol and drugs than men, yet they are likely to develop more severe physical, emotional, behavioral, and social problems compared to men. The spectrum of symptoms and signs may also differ between women and men in any given substance use disorder. Women are also more likely than men to suffer from comorbid mental health issues, including depression, anxiety, post-traumatic stress disorder (PTSD), panic attacks, eating disorders and particularly polysubstance abuse. It has also been noted that many women begin abusing drugs as a means of self-medication for these disorders.

Women with substance abuse problems may be more susceptible to rape, given their vulnerable state overall
All patients of substance use disorder, regardless of their gender, suffer from social problems, financial issues, mental and behavioral health disorders, malnutrition, hepatitis, AIDS, and other sexually transmitted diseases. However, female patients have these additional unique challenges, including having a higher rate of adverse physical effects on their cardiovascular system. They are also more likely to overdose and more sensitive to certain substances. Women with drug and alcohol addiction may be more likely to face certain financial and legal problems. This becomes even more problematic when they have children. Women with substance abuse problems may be more susceptible to rape, given their vulnerable state overall. A recent study reported that approximately 73% of female drug abusers that were surveyed had a history of rape, of whom 35% were raped while under the influence of drugs or alcohol. To makes matters worse, women engaging in substance abuse may face unplanned pregnancies as a result of poor safe sex practices due to lack of awareness/resources or while under the influence.

Female patients are also prone to pregnancy complications, leading to negative outcomes for both the mother and the developing baby. These women who abuse drugs during pregnancy are more likely to experience high blood pressure, migraines, and seizures. Their fetuses are prone to having low birth weight, birth defects, developmental delays, etc. There is a 2-3 times higher risk of stillbirths in these cases.
All of these problems are made worse by several barriers to treatment faced by women. To begin with, women are generally less likely to seek treatment than men, which may be in part due to social stigmas, childcare responsibilities, financial difficulties, transportation issues, lack of interpersonal or familial support, just to name a few.

Special care should be provided to female patients in order to improve compliance, comfort and overall chance of recovery. Some female-specific supportive approaches include onsite childcare, parenting classes, special care for pregnant/nursing mothers or those who are victims of rape, domestic violence, etc. In addition, vocational training, income support, housing assistance, social services, family and couples therapy are also very useful in helping these patients.

Odds of Dying from Opioid Overdose Surpasses Automobile Accidents

Death rate statistics in the United States now point to a startling turnaround with the likelihood of dying by opioid drug overdose surpassing the chances of dying in an automobile accident. Automobile accident deaths have long been the balancing point in conversations around the country. It is frequently said that a person has more chances of dying in an automobile than they do in an airplane. This is true.
You also hear that automobile deaths are the number one cause of preventable death. That is no longer the case, according to the Odds of Dying report put out by the National Safety Council (NSC). Opioids, their numbers say, are now the No. 1 preventable death threat in the United States.

The numbers are not only scary today, but the numbers have been on a rampage since 2011, coinciding with the arrival of street market fentanyl, which has proved to be as lethal as any illicit drug in the country. Put another way: The odds of dying by opioid overdose have probably not peaked yet. The problem, in part, is getting the message out to the public. “I can tell you without hesitancy, the general public does not like death rates,” Pain Medicine News quoted NSC statistics manager Ken Kolosh as saying. The aim of the NSC is, in fact, to put statistics in a manner in which the public can fully grasp their meaning. As such, the numbers are frightening, as they should be.

Opioids, their numbers say, are now the No. 1 preventable death threat in the United States

It breaks down this way: The U.S. population was approximately 326 million in 2017. The number of accidental opioid-related deaths came to 43,036 that year. Simply divide 326 million by 43,036 and you get one in 7,569, which are the odds of dying of an opioid-related overdose in the entire year. When you divide that by the average life expectancy, which is 78.6 years, you get one in 96. That’s the odds of dying of an opioid-related accident for someone born in the United States in 2019. Do the same numbers for other causes of death and you have heart disease, a one in six chance; cancer a one in seven chance, chronic respiratory disease one in 27, suicide one in 88. If born in 2019, the odds of dying in an automobile accident are one in 103.

Further, the odds of dying in an automobile accident have been improving over the last 10 years, while the odds of dying from overdose have been getting worse … and worse. According to the CDC, there were 47,600 opioid-related overdoses in 2017, which is 67. 8 percent of all drug overdoses. Are we done being scared? Absolutely not. But Pacific Bay Recovery is absolutely confident we have the team in place to turn your drug or alcohol addiction around.

Confidence and fear do not cancel each other out. We certainly know this is tough. We know this is difficult. We know you did not start out life seeking to be addicted to drugs or alcohol. We know how difficult this can be. We know this is scary, but we also know and abide by one absolute: Emotions can change. What if the source of your fear today – facing recovery – becomes a source of your proudest accomplishment in the future? We understand you are scared today, but how will you feel when you get back on your feet when you find you are no longer beholden to any mood altering substance or behavior?

Recovery is scary on day one. It’s scary on day two. It’s frightening for a while. We can help you get through those early fears and move on to a full, fruitful, healthy life in the future. What may seem scary, depressing and isolating today will look very different in the future. Recovery is about restoring hope. It’s about waking up every day with hope in your heart. Every day you have regained control of your life is a day of hope. You can win this struggle.

Don’t be a statistic. Call Pacific Bay Recovery, San Diego’s top drug and alcohol recovery program. Call 858-263-9700 today.

MDMA Addiction Treatment

MDMA (3, 4-methylenedioxymethamphetamine) is known by many names – Molly, ecstasy/XTC, etc. It is a synthetic drug that has a stimulant and hallucinogenic effect on humans. It was initially used in the treatment of a number of psychological issues, but given its potentially harmful effects, it is not utilized as medicine. It has the ability to lower inhibitions, enhance a sense of interconnectedness, and create psychedelic effects, which is popular among teenagers and young adults, especially in the party culture (“raves”).

MDMA effects start kicking in within an hour or so after taking a single dose and include feelings of mental stimulation, emotional warmth, a general sense of well being, decreased anxiety, as well as an enhanced sensory perception. MDMA dramatically alters an individual’s mood and perception, and its effects are similar to those experienced after taking amphetamine and hallucinogenic drugs. However, there are some users who report undesirable effects immediately, including anxiety, agitation, and recklessness. It can produce a variety of adverse effects, including nausea, chills, sweating, involuntary teeth clenching, muscle cramping, and blurred vision. MDMA overdose results in high blood pressure, faintness, panic attacks, and in severe cases, a loss of consciousness, and seizures.

We have a team of highly experienced professionals fully trained in the management of MDMA abuse disorder

It is typically consumed as a white powder form which can be applied on the gums, snorted or smoked. But more commonly, it is mixed with other substances and sold as a tablet. There is a common misconception that Ecstasy/MDMA does not lead to addiction or dependence; it is actually opposite to that – It is highly addictive and chronic use leads to serious long-term, overall poor health, wellbeing and quality of life. MDMA addiction may also lead to the development of alcohol addiction and other drug and behavioral addictions, as polysubstance abuse is quite common. Long-term users of Ecstasy/MDMA can lead to tolerance, which is a key factor in the development of addiction.

As devastating as it is, MDMA addiction is fully treatable. It takes will power and determination of the patient, and with the support of loved ones and experienced professionals, recovery from this abuse disorder is achievable. It takes a team of highly trained psychologists, psychiatrists, therapists and other mental health professionals who have a thorough understanding of this type of substance abuse disorder to comprehensively treat it. Each patient is unique – different background, medical history, psychiatric issues, social circumstances and physical profile, and the treatment needs to be bespoke, individually tailored with support for each individual. Treatment may include outpatient therapy, 12-Step support group, partial hospitalization or residential treatment, family therapy, Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), biofeedback/neurofeedback, hypnotherapy, recreation therapy, etc. We have a team of highly experienced professionals fully trained in the management of MDMA abuse disorder, providing the full gamut of treatment options customized for each patient so that they can have the best shot a full and lasting recovery.

Genetics and Addiction

Addictions or substance abuse disorders are a diverse set of common, complex diseases that affect millions of people worldwide. The environmental factors that predispose to substance abuse are well known, but the question is whether genetics play a role as well. It is becoming evident that there are shared genetic and environmental etiological factors at play. Genetic studies and other analyses are clarifying the origins of addiction and the role genes play in their development. This knowledge of genetic factors in etiology and treatment response can bolster the personalized treatment of these disorders and even prevent them.

Addictions are chronic and often relapsing psychiatric disorders with maladaptive and destructive outcomes that affect not only the individual, but also one’s family, community, and society. Just talking about alcohol alone, around 2 billion people consume alcoholic beverages and 76.3 million of these have an alcohol use disorder. The second most abused drug is tobacco, with 1.3 billion users worldwide. Approximately, up to 200 million people worldwide consume illicit drugs.

Studies reveal that an individual’s risk for substance abuse disorder tends to be proportional to the degree of genetic relationship to an addicted relative
Addiction is characterized by three phenomena, regardless of the type of agent of abuse: craving (preoccupation/anticipation), binge/intoxication, and withdrawal/negative effect. The initial stages are dominated by impulsivity and positive reinforcement that drive drug-seeking behavior. These are replaced by compulsivity and negative reinforcement in the later stages of the addiction cycle. Addictive drugs have been found to induce adaptive changes in gene expression in brain reward regions, leading to tolerance and habit formation. These processes are implicated in the development of relapse as well.

Genetics supposedly play an important role in determining which treatment modalities are effective in these patients. This can induce a paradigm shift in substance abuse disorder therapy as currently, the clinical options are untargeted and only partially effective. Inherited variation is thought to affect the initiation and maintenance of drug use, and new therapies and preventive strategies could be developed and better targeted to individuals.

Addictions have been found to be moderately to highly heritable. Family, adoption and twin studies reveal that an individual’s risk for substance abuse disorder tends to be proportional to the degree of genetic relationship to an addicted relative. These heritabilities are not the same across the board – it is 0.39 for hallucinogens, and 0.72 for cocaine. An important study (Virginia Twin Study) revealed that while familial and social factors play a stronger role in the initiation and use of nicotine, alcohol, and cannabis in adolescence, there is an increasingly greater role of genetics in the same as one grows older.

It must be noted that the underlying pathogenesis of these substance use disorders is complex, and while there has been some progress in unraveling the genetic factors that are linked to their development and to one’s response to therapy, there is still a lot that we don’t know about how genetic factors interact with environmental factors in the natural history of these conditions. But it is encouraging to see that this knowledge has the potential to guide prevention and management practice in this field.

Opioid Alternatives for Chronic Pain Relief

As we all know, we are in an opioid epidemic in this country. But the good news is that the numbers are beginning to go down. Having said that, the job is still not done. The main reason we still high opioid use (and eventually abuse) is that we still have a very high prevalence of chronic pain (almost 1 in 10). And opioids are still being overprescribed. Hence, there is a pressing need to use opioid alternatives for chronic pain relief.

Not only that opioids have a very high addiction potential  (15-fold greater risk for those who have been taking opioids for three or more months), but also they are not very effective in the management of chronic pain. There are a number of alternative strategies that have been found to be effective against chronic pain, such as cognitive behavioral therapy, acupuncture, medical massage, physical therapy, etc.

Chronic pain is defined as a pain condition that lasts for more than six months. Studies have shown that chronic pain involves the same areas of the brain as the emotional disturbance. Emotional pain is treated with alternative methods, so it is worth exploring if chronic pain can be effectively managed that way as well.
Opioid use has yet to be seen whether these efforts made any difference in preventing addiction
Many healthcare providers have made initiatives to minimize the chance of opioid addiction. Pain clinics assess people for risk of addiction, have them sign a medication contract, educate and counsel them on the risks of addiction and other side effects, perform urine drug testing, undertake pill counts, etc. But it has yet to be seen whether these efforts made any difference in preventing addiction.

The opioid alternatives that are being used for chronic pain management include nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants and antiseizure medications. Nonpharmacologic options include cognitive behavioral therapy, exercise therapy, physical therapy, etc. There are also some interventional approaches such as nerve blocks, neuromodulation, etc. These methods have been found to be effective in chronic pain management.

There is now one-stop-shop type of pain clinics where the patient can see a physician, a physical therapist, a psychologist, a massage therapist, an acupuncturist, etc., for one’s pain complaint. However, these approaches can be expensive with limited or no insurance coverage.

 

It is being widely understood that opioids can only provide short term from severe acute pain and are ineffective for lasting relief from chronic pain. Instead, a better approach for the latter is to use a combination of alternative modalities mentioned above. But these methods take patience and effort because complying with them takes commitment and the results are not immediate. But when the patient sticks with them, the results are often very rewarding.

It is important to note that these alternative methods are much more effective once somebody is not on opioids. The reason may be psychological, at least in part, that the patients have gotten used to finding immediate relief that comes with taking opioids even if its temporary. But working closely with the therapists and with some encouragement and perseverance, patients are able to overcome chronic pain through these safe methods.