Chronic pain patients have a multitude of possible treatments available for the management of symptoms. Strategies often include exercise, physical therapy, chiropractic care, massage, injections and medications. One of the more frowned upon treatments is opioids, but sometimes they are used successfully. With the current opioid crisis, many pain patients fear using them and want to be safe if they have them in their possession.
The most important rule with regards to use of any medication, especially opioids, is to never take more than what has been prescribed. Opioids can build up in the body and suddenly become deadly if too much is taken. Running out early can cause opioid withdrawal syndrome and while it is uncomfortable, it is not dangerous to your health. If you are taking opioids, expect your doctor to closely monitor your medication and behavior while taking these drugs. Since they are highly addictive and abused, most doctors will tightly control prescriptions and refills. Drug testing, opioid contracts, behavior screenings, depression screenings and monitoring of other medications are standard. Mixing of medications like sedatives, anti-anxiety treatments like benzodiazepines, and using any street drugs often will lead to ending a prescriptions for opioids, and often there is zero tolerance of any safety rules due to the extreme danger inherent with opioid misuse.
Mixing Street Drugs and Opioids
The latest step in opioid safety is the prescribing of naloxone in addition to the opioid. Naloxone is a drug that can block the opioid receptors for most opioid-type drugs, and it can prevent an accidental or purposeful overdose. In Minnesota it can be obtained at most pharmacies even without a prescription, and can be given effectively as either an injection or as an intranasal spray. Anyone who is routinely taking an opioid or has opioid medications in the home should likely have naloxone too, in case they accidentally or purposefully take too much, or someone else takes their medications. If you are on these medications, ask your doctor about having a safety prescription for naloxone.
Using street drugs for an addiction to opioids or for pain is high-risk behavior. The singer Prince was using Percocet obtained from street sources to control his hip joint pain. The Percocet he obtained had allegedly been mixed with fentanyl, which is an extremely potent opioid and caused his overdose death. If you are addicted to opioids, are using them to get high, use heroin, or have family or friends that is misusing opioids, you can obtain naloxone and this may save someone from an overdose death.
Successful Opioid Treatment
Opioids can be helpful in treating pain, but they are extremely difficult to use due their limited safety. More physicians are very reluctant to prescribe these medications and their long-term efficacy and safety is limited. More information has become available on how opioids actually tend to increase pain over time versus being helpful. Pain management specialists will work with patients to find alternative strategies to these dangerous medications.
One last issue with regards to all medications, especially opioids, is how to dispose of unused or outdated prescriptions. In the past, medications were often flushed down the toilet or thrown out in the trash. The environment does not do well with those methods, and it tends to lead to contamination of our waterways and ground water. Freshwater fish are starting to show significant levels of some commonly disposed medications. The best way to get rid of unwanted medications is to bring them to your local police or sheriff’s department where they have disposal lock boxes. These medications then are handled as hazardous waste and usually incinerated at high temperatures to completely destroy them and turn it to relatively safe ash.
If you’re struggling with an opioid addiction or want a doctor to help get to the bottom of your pain, contact Dr. Cohn today.
Thomas Cohn, MD
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