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Posted on January 5th, 2016

Looking beyond painkillers to tackle chronic pain

Looking beyond painkillers to tackle chronic pain

Let’s be clear: pain is bad and debilitating. Chronic pain in particular can ruin lives, depriving a person of the enjoyment of daily life and activities. Many Americans live with chronic pain from injury or medical condition, and it’s easy for a person who’s never dealt with ceaseless discomfort to speak out against pain pills. Some conditions only respond to the strength of opiates.

But it’s also worth noting many Americans have perhaps been overprescribed painkillers. According to a Centers for Disease Control and Prevention (CDC) report, healthcare providers wrote 259 million painkiller prescriptions in 2012, enough for every American adult to have his or her own bottle of pills. The CDC also states that 46 people overdose from prescription painkillers daily.

Painkillers address pain, true. It’s also highly addictive and can be a gateway to the abuse of street opioids like heroin. Additionally, some conditions simply don’t respond to opioids, but those are still prescribed. Is there another way?

When pills don’t work

Take fibromyalgia. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD) defines the condition as a chronic disorder causing widespread pain in the body. Often lumped in with other rheumatic conditions like arthritis, fibromyalgia is different because unlike arthritis it does not inflame and damage the joints. However, fibromyalgia still causes intense pain along with fatigue and memory problems, and the 5 million Americans with fibromyalgia – 80 to 90 percent of which are women – are often in great pain.

Studies cited by Medscape.com, a web resource for physicians, have suggested fibromyalgia pain does not respond well to opioid medications. Yet, many fibromyalgia patients are prescribed these potentially addictive drugs. Currently, around 30 percent of American and Canadian fibromyalgia patients have reported using opioids for pain relief. “It can be a misdirected treatment that becomes a problem in and of itself, because it doesn’t reduce the pain. And it can make normally pleasant experiences feel less rewarding in the long run,” says psychologist Mary Davis, Ph.D., from Arizona State University (ASU).

Surprising alternatives to pills

Davis has spent the past 15 years at ASU studying chronic pain. Her research has helped develop new methods for managing pain that do not rely on prescription painkillers. Using randomized clinical trials with patients affected by chronic back pain or fibromyalgia, Davis compared three different approaches to pain management. The first was simple education: Davis says giving people information about their pain and its sources helps – if the patient understands their condition is related to diet or sleep habits, it can help them manage their pain better. “People experience a boost simply by getting information. Knowledge really is power,” Davis told ASU News.

The second was cognitive behavioral therapy (CBT), which encourages patients to change how they think about their pain. Many patients with chronic pain often feel hopeless and defeated by their pain. A case in point is ASU graduate Nicole Zeig, who is affected by a condition called Ehlers-Danlos syndrome type 3, a disorder affecting the body’s connective tissues and causes chronic pain. After herniating two disks in her back when she was 16, Zeig was prescribed opioids but fell into addiction. “I was so focused on the pain – I was trapped by it. I felt like I was always going to be in pain and there wasn’t any way out,” Zeig told ASU News.

Davis calls this sort of thinking “catastrophizing,” which can make patients feel even worse. CBT can help patients think less negatively about pain, perhaps by finding ways to distract themselves. “Rather than thinking that the pain will be horrible forever, which tends to make the situation worse, a person might try thinking, ‘I know that this is just a flare and it will get better soon’,” says Davis.

Finally, mindfulness mediation allows the patients to regulate their own emotions. Sometimes patients respond to pain by automatically taking painkillers. Meditation can teach them to consider their options and make their decisions consciously.

Davis said all three alternatives were successful in her studies. Zeig stopped using painkillers and in 2014 graduated from ASU with a master’s degree. Although still living with pain, Zeig uses physical therapy and hypnosis to manage it. “I did not think I was capable of living without pain medication. I think that people who are in pain are either a victim to it or they are active participants in their lives. Once I took an active role in overcoming it, it really does work,” said Zeig.

Again, chronic pain can be a devastating problem for many people, but so is opiate addiction. The Arizona Detox Helpline is an excellent resource if you’re looking for more information on addiction issues, detox programs or treatment options. If you or someone you know is struggling with addiction to painkillers, please call us at 866-593-8453 or contact us via an online chat. Relief can start today.