A new NPR-IBM Watson Health Poll suggests 18 percent of Americans suffer pain that interferes with daily lives. Over-the-counter pain relievers are the most commonly used solution. Are pain pills as good—or as bad—as we’re told?
According to NPR, one possible cause for the increased report of significant pain as compared to previous studies may be a decline of opioid prescriptions as the health industry becomes more conscious of opioid addiction. However, of those Americans who did report daily pain, over-the-counter pain relievers were cited as the most common method of treatment. With painkillers in the spotlight the last few years, where does the truth lie?
Relief, with a Catch
Opioid prescriptions are incredibly common in the United States. Recently, though, the use of opioids is slowly decreasing due to the increased focus on opioid addiction. However, the use of opioids is still near its all-time peak.
“According to the Centers for Disease Control and Prevention—the CDC—health care providers write more than 250 million prescriptions for opioids every year,” said Dr. Barbara K. Bruce, Clinical Health Psychologist in the Mayo Clinic Department of Psychiatry and Psychology. “That’s about one bottle per adult in the United States. And we have plenty of evidence that use of opioids in the short term is safe and beneficial for the majority of patients with acute pain.”
Acute pain is defined as any short-term pain, whether you accidentally hit your thumb with a hammer during basic home repair or you are recovering from a surgery or a car accident. Broken bones, burning your hand on the stove, headaches, and stubbing your toe are all acute pain. Chronic pain, on the other hand, is a pain that lasts longer than three months. So, Dr. Bruce provides this information about opioids with several caveats. First, she specifically says the evidence pertains to short-term use of opioids. Second, she mentions “the majority of patients.” Third, she specifies acute pain.
What about long-term use? “The CDC found there was little data on the safety of using opioids for a year or more—and what they found wasn’t encouraging,” Dr. Bruce said. “What they found was that long-term use led to addiction and tolerance and that both of these sharply increased the risk of overdose. That’s why the CDC goes on, in its recommendation on opioids, to advise that physicians not provide opioids as first-line or routine therapy for chronic pain outside of active cancer, palliative care, or end-of-life care.”
Avoiding Harmful Drug Interactions
Unfortunately, many of us depend on more than one prescription to aid our health. In addition to antibiotics, blood pressure medication, cholesterol pills, and so on, our use of pills can include painkillers like opioids or simple over-the-counter, nonsteroidal, anti-inflammatory medicines like aspirin or acetaminophen. To be on the safe side of preventing opioid addiction, there are several steps worth taking.
“If you see different doctors, each of them needs to be aware of all the medication you’re taking—including over-the-counter medications, such as aspirin, allergy medicine, and even nutritional supplements,” Dr. Bruce said. “The second step is to order all your medications through the same pharmacy whenever possible. The pharmacy has systems in place that alert pharmacists to potentially dangerous interactions between the drugs you’re taking.”
The third step is the little piece of paper that’s usually stapled to our bag of medicine, which most of us likely throw away without reading. “That’s how you keep yourself informed of any potential side effects, so you can monitor your own response to the medication,” Dr. Bruce said. “The final step is disposing of old medications properly.” She said that medication loses its potency after its expiration date and that the opioid crisis is caused partly by people using leftover medications they’ve found that weren’t prescribed to them in the first place.
As is often the case, there isn’t one cut-and-dry answer. Short-term use of opioids for acute pain is safe for most people, but long-term use for chronic pain can lead to trouble. Your primary care physician can help you decide which treatment regimen is right for your specific health needs.
Dr. Barbara K. Bruce contributed to this article. Dr. Bruce is a clinical health psychologist in the Mayo Clinic Department of Psychiatry and Psychology. She holds a Bachelor’s Degree in Psychology and a Ph.D. in Clinical Psychology from Louisiana State University in Baton Rouge. She holds a Master’s Degree in Physiological Psychology from the University of New Orleans.