Opioids often are the go-to pain killer for everything from back aches and injuries to post-surgical pain, as evidenced by the more than 300 million prescriptions written each year. While they can help with moderate to severe short-term pain, opioids are not without risk. Because they have significant side effects, including an increased risk of addiction and overdose, the American Society of Anesthesiologists suggests those who take opioids ask some tough questions – including if it is time to consider alternatives.
Kathleen Callahan understands the dilemma. She suffers from a condition that causes painful cysts that required multiple surgeries resulting in post-surgical and chronic pain for which she took opioids for years. Despite being on a high dose of opioids, she still had chronic pain. So she turned to Anita Gupta, D.O., Pharm.D., a physician anesthesiologist who specializes in pain medicine.
“When I was on opioids long-term I couldn’t function, couldn’t be involved in my children’s lives and my work was suffering,” said Kathleen. “Dr. Gupta helped me manage my pain so life is livable. Now I exercise, go out with friends and go to my kids’ activities.”
“Kathleen and I had some difficult discussions. I didn’t think the medications were helping her anymore and I was truthful with her,” said Dr. Gupta. “She asked some hard questions, and I helped her move forward and cope with her pain. Since she’s been opioid-free Kathleen is vibrant and energetic. She has her life back.”
If you are taking opioids or your physician has prescribed them, the American Society of Anesthesiologists suggests asking yourself (and your physician) some tough questions:
• Are opioids affecting my quality of life? Opioids have many side effects, ranging from severe constipation, mental fogginess and nausea to depression. Kathleen said she was “exhausted, cranky, depressed, constipated and gaining weight.” She realized the side effects of opioids were worse than the pain itself, motivating her to seek other options.
• What are my concerns about taking opioids – or stopping them? With the media attention surrounding opioid risks, many people worry they:
- are being judged by others
- may become addicted or overdose
- won’t be able to control their pain if they stop taking opioids
Ask your physician about obtaining naloxone, a drug that can reverse an overdose. If you take opioids when you don’t have pain or use more than directed, you may develop a dependence. Talk to your physicians about alternatives to manage your pain.
• Is it time to consider other methods of pain management? Opioids are most effective in the short term. If they are taken for chronic pain, they should be part of a “multimodal” plan that includes other methods of pain management, including:
- Injections or nerve blocks, which can short circuit muscle and nerve pain.
- Electrical stimulation and spinal cord stimulation devices that send electrical impulses to block pain.
- Physical therapy, which strengthens muscles to improve function and decrease pain. Whirlpools, ultrasound and massage can help, too.
- Alternative therapies, such as acupuncture, biofeedback, meditation, deep breathing and relaxation, which help you learn how to ease muscle tension.
• What type of physician can best help manage my pain? If you have severe or ongoing pain, be sure to see a physician who specializes in pain management, such as a physician anesthesiologist. These specialists have received four years of medical school and additional training in a medical specialty, followed by an additional year of training to become an expert in treating pain. They have the expertise to best help you manage your pain.
“If I was still on opioids I would be overweight, inactive, not involved in my children’s lives and depressed,” said Kathleen. “When you have a physician like Dr. Gupta who you trust and who shows you there’s another way, it’s just amazing. It’s night and day.”
For more information, download ASA’s Asking the Hard Questions About Opioids. To learn more about the critical role physician anesthesiologists play before, during and after surgery, visit www.asahq.org/WhenSecondsCount.