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While opioid drugs, such as hydrocodone and oxycodone, are widely prescribed to treat moderate to severe pain, lawmakers and regulatory agencies both agree that this has led to an opioid abuse and overdose epidemic in the United States.
Between 2000 and 2014, the Centers for Disease Control (CDC) noted that over a half-million people died due to an overdose on narcotics, including morphine, prescription painkillers, and heroin. Roughly 78 Americans die every day due to opioid overdose.
To help people struggling with opioid addiction, replacement therapies, such as methadone and buprenorphine, have become very popular in the last several decades. However, these drugs are also opioids; methadone is a full opioid agonist, while buprenorphine is a partial opioid agonist. These medications act on the opioid receptors, much like other narcotics, although they do not induce the same euphoric high in people who have developed a tolerance to opioid drugs. Still, for some people struggling to overcome opioid addiction, replacement therapies can become a new target for drug abuse and addiction.
There are several other treatment options for both pain relief and overcoming opioid addiction. While these may not be effective in every scenario, they are still options to consider as the opioid abuse epidemic in the US continues to grow.
There are several kinds of non-opioid medications that can be effective for pain relief, depending on the individual’s condition.
For people who are concerned about opioid abuse, whether due to a personal or family history of addiction or other concerns, doctors may be able to find alternate treatment methods involving the above drugs.
A conversation about these concerns will also help prescribing doctor better monitor their patients for potential addictive or drug abuse patterns.
For people who want to overcome an addiction to opioid drugs, and who do not want to use methadone or buprenorphine as maintenance and tapering therapies, there are some other options available.
Naloxone is an opioid antagonist that temporarily binds to opioid receptors and kicks opiates out. The medication is more commonly used to reverse an opioid overdose long enough for emergency medical services to arrive and begin other life-saving treatments. However, the prescription brand name medication Suboxone, a combination of naloxone and the partial opioid agonist buprenorphine, is used as “abuse-proof” maintenance therapy.
Both of these medications are considered nonaddictive and have very few side effects.
No medication is without side effects and potential risks. It is important for doctors and patients to have frank and detailed discussions about concerns around opioid drugs and treatments aimed to overcome opioid addiction. Different therapies work for different people. For people who wish to avoid or overcome addiction to narcotic drugs, there are several options that do not involve narcotics at all. Still, these medications also have risks that the person ingesting them should be aware of.
For people who do not want the risk of becoming addicted to opioid drugs, it is important to know that there are other potential treatments for all kinds of pain. Whether the pain is moderate and expected to go away in a brief period of time or the pain is chronic and part of a long-term disease, there might be non-opioid options worth pursuing. Further research into these treatments and how they work could change prescribing practices around opioid painkillers and help to reduce the severity of the opioid epidemic in the US.
Those who are working to overcome opioid addiction also have options that are not opioid maintenance therapies. Medical detox followed by an evidence-based rehabilitation program is the recommended course of treatment for nearly all addictions. For people who want a faster, but still safe, process through detox and into rehabilitation programs, naltrexone, clonidine, or another medication may help the withdrawal and addiction treatment process. Use should be determined on a case-by-case basis in consultation with a physician.