DR. MICHAEL BIZZARRO
Understanding the risks of opioid pain medications
Opioid prescription medications like Vicodin, OxyContin and Percocet can be effective in treating acute and chronic pain, but they also can pose a significant danger. These medications— with an origin similar to heroin— are abused for nonmedical purposes by more than 4.3 million Americans. Every day, more than 40 people in the U. S. fatally overdose on prescription opioids, according to the National Institute on Drug Abuse.
Given these risks, people struggling with pain issues should talk with their doctors about opioid medications and non-opioid methods of pain management. The Centers for Disease Control and Prevention( CDC) recently issued new guidelines for treating patients with chronic pain, recommending that physicians consider non-opioid medications or nondrug treatments instead of or in conjunction with
opioids. Addiction recovery challenges
Many patients are in substance-abuse treatment because they have developed addictions to opioid prescription medications or their use of these medications led to heroin abuse, according to my colleague, Dr. Kapila Marambage, medical director of the Inpatient Addiction Recovery Program at Princeton House Behavioral Health. The detoxification process can be challenging.
“ In substance-abuse treatment, pain is a driving force toward relapse,” says Marambage.“ For these patients, opioids are not something they turn to just for highs— they want the drugs to alleviate pain. This creates an additional challenge for substance
HEALTH & WELLNESS
abusers and their treatment teams.”
When treating those dealing with detox-related pain or suffering from an injury or a painful medical condition, Princeton House physicians collaborate with the patient’ s pain-management specialist to develop a plan, which may include options such as …
• non-opioid medications, such as nonsteroidal anti-inflammatory drugs and the anesthetic lidocaine patch
• nonaddictive muscle relaxers
• nondrug treatments, such as exercise and cognitive behavioral therapy( including mindfulness and relaxation techniques).
In some cases, depending on the severity of opioid dependence and other comorbid factors, physicians may develop a specialized opioid pain-management plan, which can include medications such as buprenorphine or methadone, and carefully track the patient’ s usage and progress.
“ It’ s important to educate our patients about how the opioid system in the brain affects their pain thresholds, and why opioids shouldn’ t be their first choice,” adds Marambage.“ We help them understand that opioid use will only make a bad situation worse.”
Michael Bizzarro, Ph. D., LCSW, BCD, is the director of clinical services for Princeton House Behavioral Health’ s First Responder Team and a member of the NJ State PBA Clinical Services team. To learn more about Princeton House Behavioral Health’ s Inpatient Addiction Recovery Program, call 800-242-2550 or visit www. princetonhcs. org.
80 NEW JERSEY COPS ■ JULY 2017