Most people experience some kind of pain during their lives. Pain serves an important purpose: it warns the body when it’s in danger. Think of when your hand touches a hot stove. But ongoing pain causes distress and affects quality of life. Pain is the number one reason people see a doctor.
A class of drugs called opioids is often used to treat pain. One reason, explains NIH pain expert Dr. Michael Oshinsky, is that opioids work well for many people. Opioids can stop the body from processing pain on many levels, from the skin to the brain. Because they work throughout the body, he says, “Opioids can be very effective for multiple types of pain.”
But opioids also produce feelings of happiness and well-being. And they’re reinforcing: the more people take them, the more they crave them. This can lead to addiction, or continuing to take opioids despite negative consequences. Scientists have not yet been able to develop opioids that reduce pain without producing these addicting effects, Oshinsky explains.
The longer someone takes opioids, the more they may need to take to get the same effect. This is called tolerance. Having a high tolerance doesn’t always mean you’ll become addicted. But taking higher doses of opioids increases the risk for both addiction and overdose.
The U.S. is now in the grip of an opioid crisis. Every day, more than 100 Americans die from an opioid overdose. This number includes deaths from prescription opioids.
“We don’t need ‘better’ opioids. We need to move away from the reliance on opioids for developing pain treatments,” Oshinsky says.
NIH is funding research into new and more precise ways to treat pain. It’s also working to develop new treatments to combat opioid misuse and addiction.
Opioids Not Always Needed
Opioids are often prescribed for acute pain. Acute pain is short-term pain, the kind experienced after an accident or an operation. But other drugs may be just as effective for acute pain, even after surgery, explains Dr. Dena Fischer, a dental health expert at NIH. Some of these drugs, like acetaminophen or ibuprofen, don’t require a prescription.
People may think that prescription drugs work better for acute pain. But that’s often not the case, Fischer says. Using something other than an opioid first can be especially important to manage acute pain in fields such as dentistry, she adds.
Many people receiving opioid prescriptions from dentists are teens or young adults who have never been prescribed an opioid before.
“Research is starting to tell us that people who receive an opioid prescription as a teenager have a tendency to continue to take opioids for non-medical purposes in the long term,” Fischer says.
Healthcare providers who decide their patient needs an opioid are now being encouraged to give only a few pills at a time. People who receive shorter prescriptions are less likely to misuse their pills by taking more than prescribed or taking them after the pain is gone. This also cuts down the chance that the pills could be taken by others.
Source: NIH News in Health