Painkiller alternatives may reduce risk of prescription opioid abuse

By WV Attorney General Patrick Morrisey

Opioid abuse is devastating our state, and too often it starts with something as seemingly harmless as the prescription of an opioid-based pain medication.

Powerful painkillers, such as oxycodone or hydrocodone, are prescribed to provide temporary relief, but do nothing to address the source of pain.

Long-term prescription opioid use creates a tremendous problem where patients develop a tolerance and dependence for pills that share characteristics similar to heroin. This ultimately turns one’s search for temporary relief into addiction, accidental overdose, coma and death.

West Virginia tops the list for overdose deaths in the nation, and this cycle must change. The answer lies with patients and prescribers choosing safer, non-narcotic alternatives.

That’s why my office created the first substance abuse fighting unit by an Attorney General in West Virginia. It promotes a focused effort on enforcement, prevention through education and the pursuit of alternative treatments for injury or pain.

The process must begin with a thorough physical examination and the prescriber considering every available alternative to opioid medication. The price of anything less is potential addiction, overdose and death.

Patients must feel empowered to ask for non-opioid based medication and treatment. These options include physical and occupational therapy, chiropractic medicine, massage therapy, acupuncture and over-the-counter medication.

Such a strategy follows our office’s best practices for prescribing and dispensing opioid drugs. This initiative garnered support from more than 25 national and state stakeholders. It also laid the foundation to cut prescription opioid use by more than 25 percent.

But the key to achieving that goal is use of non-opioid alternatives. Highly addictive pills can no longer be the first choice in treating aches and pain.

Physical and occupational therapy, non-medication approaches to physical rehabilitation and improving functionality, offers an interdisciplinary approach to pain management that focuses on physical, social and emotional health. In some cases, the technique has been shown to improve a patient’s overall health by assessing performance issues in everyday living.

Chiropractic care and doctor-initiated osteopathic manipulation therapy have been shown to be as effective as exercise therapy or standard medical care for pain, particularly for lower back pain. This type of treatment also improves functionality in the case of injury.

Massage therapy has proven effective in the short-term management of pain, particularly pain isolated to one area of the body such as the lower back or neck. One clinical study found few adverse effects resulting from massage as a pain management technique.

Acupuncture offers short-term comfort as well as increased functionality of the injured body part, according to some studies. One study found patients undergoing total joint replacements reported feeling a 45 percent reduction in pain after receiving acupuncture treatments.

Over-the-counter pain medications are shown often to be more effective in treating pain than medications that can lead to addiction or death. Acetaminophen, ibuprofen or a combination of the two readily-available pain relievers can reduce pain without the risk of addiction and can be prescribed in larger doses as needed.

These non-opioid alternatives provide West Virginians a much safer option. They also cut down on the selling or sharing of pills, and prevent medications from accidentally falling into the wrong hands – such as those of a child.

Our goal is to reduce misuse of prescription medication while preserving legitimate patient access to necessary treatment, such as active cancer treatments or palliative and end-of-life care.

My office will not relent in working toward a healthier, drug-free West Virginia.

Our state has a great deal of potential, but drugs decimate our workforce, shatter ambitions born in adolescence, rip families apart and leave too many to mourn the passing of those who overdosed one too many times.

With caution, education – and a sensible approach to pain management – I have faith that West Virginia can curb its opioid epidemic and we can build a safer, brighter future for our state.

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