Opioid painkillers are killing thousands of Americans -- there are alternatives

President Trump has promised a major announcement and action on the opioid abuse crisis in the coming days – welcome news to deal with a growing and deadly problem.

The Center for Disease Control and Prevention reports that almost 2 million Americans abuse or are addicted to opioids and says that “from 1999 to 2015, more than 183,000 people have died in the U.S. from overdoses related to prescription opioids.” That’s a quadrupling of the death rate from these prescription drugs since 1999.

Even before the president’s upcoming announcement, his administration has begun taking action. Food and Drug Administration Commissioner Scott Gottlieb is revising the rules for approval and removal of opioids from circulation, and enhancing and expanding health care provider opioid education to include nurses and pharmacists.

Attorney General Jeff Sessions is identifying and prosecuting prescription mills that facilitate dependencies and addiction.

But how many primary care providers are attuned to looking past their prescription pads and sending pain patients to chiropractic care, biofeedback, yoga or other therapies that still carry the connotation of being alternative?

An important step in combating the opioid epidemic is to cut the skyrocketing growth of opioid prescriptions. About 38 percent of the adult U.S. population, amounting to nearly 92 million people, took opioids they were prescribed in 2015, the National Survey on Drug Use and Health has found.

The best way to do deal with the epidemic is to address the sources of pain, rather than just managing the symptoms with opioids.

The vast majority of opioid abuse and addiction cases begin with doctors and other health care providers offering relief from pain. Opioids provide the relief, but not by addressing the pain. Instead, the drugs induce a numbed and euphoric state in which suffering is temporarily masked.

However, short-term relief can lead to increased future pain if the underlying source of pain is not healed. And the pills put patients – and everyone with access to their medicine cabinets – at risk of dependence.

For retired Army Brig. Gen. Rebecca Halstead, who was America’s first female commanding general in combat, chiropractic care was the right alternative. She says it saved her life.

When Halstead suffered unmanageable pain due to chronic fibromyalgia the solution offered by the military was multiple prescription medications. “I refused and sought out other solutions,” she says.

Halstead says that opioid abuse and addiction “have put our nation at-risk, with millions of American lives literally hanging in the balance. Unfortunately, people get prescribed addictive painkillers like oxycodone, hydrocodone and percocet, and the downward journey begins. When these prescriptions are no longer available or affordable, they seek out cheaper and more potent drugs like heroin and fentanyl. The results are shattering, as more than 90 Americans die each day from drug overdoses.”

An April 2017 report on lower back pain in the Annals of Internal Medicine recommends that non-drug treatments for chronic cases, including “exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation.”

And for those cases where treatment with drugs is desired, the report recommends that “clinicians and patients should select nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants” rather than opioids.

Regarding opioids, the report recommends that “clinicians should only consider opioids as an option in patients who have failed the aforementioned treatments and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients.”

But how many primary care providers are attuned to looking past their prescription pads and sending pain patients to chiropractic care, biofeedback, yoga or other therapies that still carry the connotation of being alternative?

As a long-term pain sufferer, I was at risk of opioid addiction every time a lower back muscle spasm attack immobilized me over a 20-year period. I saw a variety of primary care and sports medicine doctors, but the attacks kept coming.

Then an ill-timed episode grounded me while traveling in China over a dozen years ago. I was forced to seek treatment that I would never have considered at home. In western Hubei Province, with no expatriate medical facilities available, I received a 15-minute treatment of acupressure and heat from a doctor of Chinese medicine. I was on my feet a few minutes later, I’ve never had a lower back muscle spasm again.

My experience made me aware of the value of alternatives that are available that I had previously never considered.

There’s an old saying that “the road to hell is paved with good intentions.” Doctors and other health professional who prescribe opioids do so with good intentions to ease suffering of their patients. Patients take the drugs with the understandable intention of easing severe pain. But the bad outcome of opioid addiction has created a hellish nightmare that must be addressed.

I look forward to President Trump’s upcoming announcement and action by his administration.