The misuse of opioids, including prescription pain relievers, heroin, and synthetic opioids, has become a serious health and socio-economic issue in recent years. Approximately 115 people die from opioid overdose every day and the overall cost of just prescription opioid misuse is more than $75 billion a year, in the United States alone.
One of the significant causes of the opioid crisis in America relates to the constant prescription of drugs for minor injuries and chronic pain. In the 1990s, there was widespread belief that new prescription pain relievers didn’t have the same addictive properties as the drugs from which they were derived, such as morphine and heroin. However, as these prescriptions became more common, overdose rates also rose, and studies showed that the new drugs could be just as addictive.
A common issue in medical care is that pain is often thought of as strictly physical, while ignoring the psychological components. It is a sensory and emotional experience, as well. The primary purpose of pain is in alerting your body to physical risk. However, in the case of chronic pain, which is often present in Workers’ Compensation claims, a continuous alert can actually be detrimental because your body can’t determine how to react.
This leads to people seeking either expensive and excessive specialty care or relying on drugs to dull their body’s receptors. Opioids are especially effective in this, because they block your perception of pain and boost your feelings of pleasure. However, with long-term use, these feelings fade and increases in dosage are required.
In order to reduce the reliance on opioids, a shift must occur in our process of pain management.
Effective Pain Management
Pain management should begin with quick and accurate pain assessment. Many people are incapable of identifying what is causing their pain without medical assistance. Instead of prescribing drugs or medical procedures immediately and reacting based on their success, we need to consider the psychological factors that cause and exacerbate injuries in the first place. In order to better help injured workers, they need to be taught how to understand and deal with their own pain psychologically. Dealing with an injury immediately and addressing the potential environmental or behavioral causes prevents the injury from deteriorating and reduces the chance that it becomes chronic pain later.
Therapeutic Options
Cognitive behavioral therapy is an intriguing option for chronic pain. It teaches strategies and skills to help a patient move forward with their treatment safely by changing patterns of thinking and behavior to affect mood. It also seeks to create a more organized plan for care and to actively involve the patient in their treatment, so they can learn to help themselves. Stress and fear can have a profound effect on recovery and oftentimes just minor behavioral changes can make a difference.
Behavioral intervention is especially beneficial when applied in conjunction with a functional restoration or return to work program. These programs combine a variety of therapeutic practices to initially help with pain management and rehabilitation through physical therapy and relaxation and then reduce the risk of future injury by exercise and vocational training.
Alternative Pain Management
While medical marijuana is still illegal in many states, it’s growing legalization make it a potentially viable future option for pain management. While the psychoactive elements of THC-heavy strains still need to be studied to determine their long term effects on a user, studies on CBD-only strains have shown to be incredibly effective in managing symptoms that are otherwise difficult or impossible to control. In particular, CBD-only strains have had positive results treating seizures, arthritis, and chronic pain. However, unless medical marijuana is federally approved, it is unlikely to be covered as treatment in workers’ compensation cases.
Certain over the counter drugs can also be effective in pain management without the serious threat of addiction and abuse. Acetaminophen can offer some pain relief, while certain antidepressants can be useful in treating chronic pain and nerve damage.
Certain medical procedures and services also have the potential to be effective in specific scenarios. Chiropractic care can be helpful in some situations to provide limited relief, though they aren’t often considered in workers’ compensation cases. This also applies to other treatments, such as acupuncture and massage therapy, which can work in the short term but should only be used at the recommendation of a physician.
Prehab
One final and important aspect of pain management is simply prevention. By applying similar principles used in cognitive behavioral therapy, it is possible to greatly reduce your risk of injury by focusing on mental health and wellness, relaxation techniques, and stress avoidance. Understanding the potential risks involved in your job allows you to avoid situations that may lead to injury. It can be helpful to proactively visit a psychologist to help you identify risky behavior and for general checkups of well being and mental health.
For more information, check out our blogs on return to work programs here and stress management in the workplace here.
