Cut off from pain medication by your doctor? Here are opioid alternatives

If you’ve long relied on opioid pain-relief for chronic pain and your doctor says you can’t have them anymore, what can you do? That’s the question on everyone’s lips after the Therapeutic Goods Administration (TGA) made it more difficult for chronic pain patients to obtain the pain-relief medication earlier this year. Doctors were told to only prescribe opioids when the benefits to the patient outweigh the risks.

The move was made in response to concerns about opioid-related overdoses. According to the TGA, every day in Australia, nearly 150 hospitalisations and 14 emergency department admissions involve opioid harm, and three people die from drug-induced deaths involving opioid use.

But the new changes are taking a particular toll on one Starts at 60 reader who has been on pain patches to treat chronic pain for years but was recently cut off by her GP due to the new changes. So, with the help of Dr Hester Wilson from the Royal Australian College of General Practitioners (RACGP), we decided to look into what other alternatives are out there for long-term users.

What are opioids and why are there hesitations around them?

Opioids are basically a group of pain-relieving drugs that work by interacting with opioid receptors in your cells. They’ve been used for thousands of years but the popular pain-relief medication has in recent years been labelled as dangerous due to its many life-threatening side effects.

Dr Wilson says while there’s no doubt the medication is fantastic for the management of severe acute pain, for people in palliative care and those with cancer pain, it does come with “quite significant risks and harms”, including constipation, sleepiness and terrible withdrawal symptoms when you try to stop, not to mention, in some cases, they can also negatively affect the health of your brain.

“You’re likely to have side effects… and in a group of people it leads to overdose, and in some of those people it’s fatal and that’s just tragic,” she says, adding in many cases, people become hypersensitive to opioids if they take them long-term, meaning patients typically need to use increased dosages to manage pain.

“For many people, it actually stops working,” Dr Wilson says. “After a period of time, it becomes less effective.”

In fact, a study, published in the Journal of the American Medical Association by McMaster University researchers, found opioids may only help slightly when it comes to treating non-cancer pain.

Dr Wilson adds opioids can also pose a significant risk for older Aussies with other pre-existing conditions, explaining that: “As you get older, your risks [increase] because of other health conditions.”

Alternatives to opioids

The good news is there are safe alternatives out there for alleviating pain and, according to Dr Wilson, one of the most effective ways to manage pain includes talking therapy.

“Some people might go really? [But], there’s some really good evidence that [suggests] talking to a phycologist or a counsellor to help you plan your days, activities, and the way you think about your pain… can make a huge difference.”

Other alternatives include hydrotherapy (physiotherapy treatment carried out in the water), swimming, gentle exercises like walking, normal physiotherapy and strength training. Dr Wilson adds that some people even find acupuncture and massage therapy helpful, but there’s not a great deal of evidence around them.

She says you can also take things like paracetamol for decreasing discomfort, as well as some anti-inflammatory medications like ibuprofen, however, Dr Wilson says it’s important to remember that all medications come with some side effects.

Before starting a new treatment, she recommends thinking about what is most appropriate for you and talking to your GP about it. And if you’re GP has recommended going on opioids for a short period of time, remember to do your research, ask a lot of questions, and get a second opinion if you’re not happy.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.