Ways to Reduce Narcotic Needs in Patients With Chronic Pain

According to a recent study from the National Institute of Health, 1 in 3 Americans suffers from some sort of chronic pain issue. Pain in this country amounts to cost of over $500 billion dollars. As chronic pain treatment becomes more prevalent in the healthcare system, so does narcotic treatment.

Unfortunately, what this has amounted to is an incredible and exponential increase in the amount of narcotic prescriptions being handed out for treatment. Eighty percent of these prescriptions come from primary care doctors, and approximately 20% of every doctor’s office visit in this country involves a narcotic prescription.

Tolerance is one of the main issues seen with narcotic treatment. As people receive chronic pain treatment, it may be that the same amount of medication may have less effect than before. An increased dose may be necessary in order to achieve the same pain relief.

As the tolerance problem happens over and over, the patient’s dosing will be increased to higher and higher doses. Doctors will see the size of the patient compared with the disease process (e.g. scoliosis) and the dosing will be way too high for either.

So what are the ways to decrease narcotic needs in chronic pain patients? Here are 5 ways to do it and a brief description of each below.

Interventional pain treatments

Physical therapy, chiropractic, manipulation under anesthesia, spinal decompression treatment

Substitution with non-narcotic medications

Topical medications

Psychological intervention

Interventional pain treatments can help decrease the amount of narcotics necessary for pain relief or potentially just prevent the patient from needing an increase in dose due to tolerance. These will need to be catered to a patient’s pain generator. If the patient is having pain from a degenerative scoliosis condition, there will often be pain in multiple facet joints from arthritis. Medial branch blocks and/or radiofrequency ablation may be able to decrease pain, decrease narcotics, and prevent surgery. It is important for the patient to be open to these treatments, otherwise, they may willingly fall into the trap of needing higher narcotic dosing.

A well rounded comprehensive treatment plan may allow an individual to reduce pain including PT or chiropractic. Often it is not just one treatment type that allows pain reduction. Manipulation under anesthesia and spinal decompression treatments have produced impressive outcomes for numerous back, neck, shoulder, and pelvic problems. Studies are showing that better outcomes are produced by pain clinics that are comprehensive and include multiple types of treatment, called multi-discipline.

There are quite a few non-narcotic pain medications that can be used which will potentially reduce the narcotic dependence. They may have fewer side effects and less chance for tolerance. Tricyclic antidepressants may help considerably, such as imipramine and amitriptyline. This is especially the case with neuropathic pain. Additional medications for neuropathic pain include anticonvulsants such as valproic acid, phenytoin, and gabapentin. Also, there is a non-narcotic analgesic, tramadol, which may substitute for narcotics.

NSAIDs may permit patients to achieve a baseline pain reduction that may reduce the amount of narcotics needed. Acetaminophen may also help considerably. One needs to be careful with the doses of each since NSAIDS may end up with kidney problems and acetaminophen can lead to liver problems.

Topical medications may help with pain reduction such as lidocaine patches or capsaicin cream. These may give a numbing effect that may reduce the need for narcotics.

And finally, it is well understood that a significant amount of pain is psychological in nature. Two people with the same pathology may have completely different functional situations – one bedridden and the other very functional. Psychology treatment may help chronic pain patients with being able to handle the pain better.

Want to find out more about chiropractor Phoenix AZ, then visit Preferred Pain Center’s site on how to choose the best chiropractors in Phoenix AZ for your needs.

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