What You Need To Know About Opioids

Here is why opioids are a problem. Let’s say it is Saturday evening, and John, a 47 year-old healthy male just finished showering. He is about to step out of the tub, when his foot slips from under him. Uncontrollably he falls head over heels and lands on his back. He is in absolute agony. Unable to move he begins to cry out in pain.

Luckily his wife is home to dial 9-1-1.The paramedics arrive in no time. After a quick assessment they rule out any life-threatening injuries. They make their way to the nearest emergency room.

At the ER, there is a bit of a wait. When John is finally seen, a full assessment is conducted and x-rays are taken of his back. Luckily his x-rays are normal, and there is no sign of fracture. The source of his pain is determined to be a pulled muscle.

To help relieve his pain, John is prescribed an opioid, and this is where the problem begins.

As you can see from John’s example, the above situation can happen to anyone, which is why opioids are an important issue. In 2015-2016 nearly one in seven people filled an opioid prescription in Canada, and nearly 13 people were admitted to a hospital per day in 2014-2015 due to opioid overuse.

Opioids are used to help relieve pain and provide much-needed relief. When taken for a short duration

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under medical direction, opioids can be helpful and a god-send. The use of opioids though helpful, can become very dangerous. The trouble lies in their addictive properties. Opioids work by acting on the opioid receptors in the body and the brain, the same receptors that heroin and fentanyl attach to. In fact fentanyl, heroin, oxycontin, vicodin, methadone and hydrocodone are all opioids, with similar addictive properties.

Just like heroin, opioids can become addictive. The ‘high’ or feeling of euphoria people experience when using these medications is the same as heroin. The 2017 Canadian Guideline for Opioid Therapy and Chronic Non Cancer Pain reports that opioids are associated with a 5.5% risk of addiction. This can open up the opportunity to drug abuse, and even the use of illicit drugs.

Opioids are becoming a bigger problem every year. Consider the following:

• The number of opioid prescriptions has tripled in Canada over the past decade
• In 2016, 29% of Canadians used opioids over the past 5 years
• Between 2007 and 2017 the rate of hospitalizations due to opioid use increased by over 50%
• 25% had leftover opioids at home intended for future use

As a Chiropractor, I usually see patients like John the next day. They have typically been to the ER the night before and are given a prescription of opioids. I find it is more difficult to encourage patients to exercise, stretch and to put in the hard work to get better, when they can easily pop a pill and ‘feel’ better. I don’t blame them, why put all the effort in when you can feel better by doing almost nothing.

In my opinion, for certain patients it may be better to educate and teach them how to manage the pain initially using a directed exercise and stretching program. It may be better to have a team of Chiropractors, Physiotherapists, Massage Therapists and others to help the patient initially, to help reduce the need of opioids. Patient education is also important, I find the more the patient understands about their pain, the better they can take care of it. The first few days may be difficult, but the long term results may be worth it.

Sources:

1. https://www.drugabuse.gov/drugs-abuse/opioids
2. https://www.webmd.com/pain-management/guide/narcotic-pain-medications#1
3. 3.https://www.canada.ca/en/health-canada/services/substance-abuse/prescription-drug-abuse/opioids/national-report-apparent-opioid-related-deaths.html
4. http://www.ccsa.ca/Resource%20Library/CCSA-Canadian-Drug-Summary-Prescription-Opioids-2017-en.pdf
5. https://www.theglobeandmail.com/news/national/sales-of-opiod-drug-prescriptionsskyrocketing/article26008639/