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Welcome to the Patient Hub

 

What are Opioids?

Opioids are chemicals that are either derived from the opium poppy or are synthetically manufactured by pharmaceutical companies. The many different types of Opioids all act in similar ways, attaching to specific receptors in the brain, spinal cord and gastrointestinal tract to help reduce pain.

 What are the potential side effects?

 Opioids are very much a double-edged sword. The benefits associated with their pain-relieving and euphoric effects can also bring with them unwanted health-related issues, and in some cases, addiction, should dependence on them get out of hand.

Side effects as a result of taking Opioids can include disorientation, constipation, contracted pupils, itching, addiction/dependence and nausea. When Opioids are misused or combined with substances such as alcohol, drugs or other prescription medications, the results could even prove to be fatal.

  • “In Swansea in 2017, 16 people per 100,000 died from opioids, according to the Office for National Statistics (ONS).”

 SOURCE: BBC News: Swansea has worst opioid death rate in England & Wales

Opioids can also lead to users abandoning important responsibilities in their lives as a result of the euphoric state induced by the drug. This can lead to life-changing professional and personal consequences.

Britain’s Opioid Crisis

  • “Dame Theresa Sackler, one of Britain’s richest women, has been named in a $500m (£378m) American lawsuit that alleges she helped fuel the opioid crisis…”
  • “The 69-year-old’s family own the drugs company Purdue Pharma. It created and sells the prescription painkiller OxyContin…The opioid crisis is now killing five people a day in Britain…”
  • “New York City is accusing Sackler, seven relatives and Purdue of misleading patients for two decades into believing the powerful opioid could treat chronic pain with only a low risk of addiction.”

SOURCE: The Times: Theresa Sackler of Purdue Pharma ‘helped fuel deadly opioid epidemic’

However, Sackler is only a cog in the machine driving Britain’s opioid crisis. The BBC has also stated that “Part of the blame has been directed at GPs who are handing out the vast majority of the 113,000 opioid prescriptions dispensed every day, according to NHS data.”

Opioid Addiction – How It Occurs

Addiction can be described as an inability to stop doing or using something. Due to the fact that opioids trigger the release of your brain’s feel-good neurotransmitters, endorphins, the drug is considered to be highly addictive.

Endorphins help to reduce pain and increase pleasure, creating a temporary yet powerful sense of well-being. Having said that, when the feelings wear off, you may find yourself seeking another dose. This is the first sign that addiction is forming.

Opioid Addiction – The Effects

After a while, the same dose of opioids won’t have as strong an effect as they used to – this is called tolerance. It’s often difficult to get doctors to renew your prescription or increase your dose as they are acutely aware of this, along with other associated risks.

Ask your doctor for help if you’re taking opioids and have developed tolerance. There are many options available that can help you make a change in the right direction.

Opioid Addiction – Risk Factors

Taking opioids using methods that differ from what was initially prescribed, for example, crushing a pill so that it can be injected or snorted, can greatly increase the risk of addiction. If the pill is an extended or long-acting formulation, then this already life-threatening practice becomes even more dangerous.

Taking the medication more often than prescribed or in larger doses than prescribed can also increase your risk of addiction.

How to prevent an Opioid Addiction

The safest way to use opioids is for a duration of three days or less to manage acute pain, for example, pain that follows a bone fracture or surgery. Should a need for opioids arise, work with your doctor to ensure that you take them for the shortest possible time, in the lowest possible dose and exactly as prescribed.

Opioids are not the best option for chronic pain due to their addictive nature. There is a wide range of less-addictive pain medications available for chronic pain.

What other options are available if opioids fail to relieve pain?

Should you find that opioids are not the best course of action for treating your pain or that they just simply don’t work, there are still other options available including:

Non-Invasive & Non-Pharmacological Treatments

The phrase “Non-Invasive” can be described as relating to any medical treatment or test, that does not enter any of the body spaces or cut the skin. “Non-Pharmacological” refers to interventions that do not involve medications.

Examples of “Non-Invasive & Non-Pharmacological Treatments” include:

  • Multidisciplinary Rehabilitation (whereby a team of specialists work together with the end goal of alleviating a patient’s pain)
  • Peripheral Neuromodulation (Neuromodulation devices stimulate nerves – with pharmaceutical agents, electrical signals, or other forms of energy)
  • Physiotherapy
  • Massage
  • Acupuncture
  • Psychological Therapies

Spinal Interventions and Spinal Cord Stimulation

Therapy in the form of Spinal Cord Stimulation is used to treat certain types of chronic pain. This is carried out via pulses that are delivered to a targeted spinal cord area through the use of an electrical generator.

Techniques involving Spinal Intervention can also help to isolate potential pain generators and provide therapeutic relief from the pain itself and other associated neurological symptoms.

Other Pharmacological Treatments

Anti-neuropathic medicines can help with calming down/reducing both pain sensitivity and nerve activity. Examples of such medications include:

  • Amitriptyline: Amitriptyline is a highly effective pain medication. It’s especially effective in the treatment of nerve pain, such as back pain and comes as either a liquid or tablets. Amitriptyline is available on prescription.
  • Gabapentin: Gabapentin is commonly used to treat epilepsy, however, it’s also effective in the treatment of nerve pain. It comes as either tablets, capsules or a liquid and is available on prescription.
  • Pregabalin:Pregabalin is often used to treat anxiety and epilepsy. There are also pain-relieving benefits associated with its use. Pregabalin interferes with pain messages travelling down the spine from the brain, consequently blocking the sensation of pain. The drug comes as a liquid or capsules and is available on prescription.

In summary, whilst opioids can provide a whole host of desirable outcomes, the dark side of this drug cannot be ignored. Opioids are the wolf in sheep’s clothing, should you develop a need for the drug, ensure this contact remains minimal and does not last for any significant duration.

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