Pain Control, Opioids, and Addiction

Everyone experiences pain from time to time, but according to the Centers for Disease Control (CDC) there are approximately 50 million Americans who suffer from chronic, unrelenting pain. Due to a wide variety of ailments, diseases, and conditions, these individuals require some sort of intervention in order to simply make it through the day. Of these 50 million however, some 20 million report having pain so severe, that their ability to complete daily tasks is limited, impaired, or completely impossible.

Understanding Pain

An assessment of vital signs provides critical information about an individual’s overall health. The four vital signs upon which we most frequently rely include measures of temperature, blood pressure, respiratory rate, and pulse. But according to the Australian and New Zealand College of Anaesthetists and Chronic Pain Coalition, an assessment of pain provides an even fuller picture that compliments information garnered from traditional vital signs. In fact, they believe pain is such an important factor, that it should be considered the fifth vital sign.

Pain plays a critical role in speaking to one’s well being or lack thereof. When pain becomes extreme it can hinder social interactions, the ability to work, self- sufficiency, and one’s overall quality of life. Pain does not have to be chronic or extreme to negatively impact one’s mood or ability to function however. In fact, all types of perceived discomfort can spur pain cycles that are rooted in the physical, manifest in the emotional, and create a vicious cycle that is hard to break.

Pain Assessments Determine Effective Pain Management

If a patient is in pain, their ability to understand why or effect change in their condition is near impossible without some sort of pain relief. This is why, in addition to taking a patient history that includes medical and psychosocial data, a pain assessment is critical to the provision of holistic, patient- centered care.

There are three types of scales that are used to assess pain. Numerical scales rely on the ability to self report, with “one” signifying no pain and “ten” indicating excruciating pain. Visual analog scales ask individuals to describe how they feel by identifying with pictures that indicate varying levels of pain. Pointing to a smiley face or tearful grimace for example, can effectively convey how much pain they are in. Lastly, categorical scales ask people to reveal their level of pain by using terms such as “none, some, mild, intense, and maximum.”

Methods of Pain Management

Based on the sheer number of chronic pain sufferers, it is clear that effective pain management is necessary. Some people prefer to use non medicinal methods of care, such as acupuncture,

massage, and physical or occupational therapy. While these are each effective treatments in their own right, they are not the right treatments for everybody

When non medicinal methods do not work, most people seek relief through the use of pain medication. For some, Non Steroidal Anti Inflammatories (NSAIDs) do the trick. For many others though, stronger, more powerful drugs are needed, often in the form of opioids.


Opioids inhibit communication between pain receptors and the brain. Similar to alcohol, they alter one’s ability to perceive pain, in addition to producing feelings of euphoria and relaxation. Because of their efficacy, opioids such as Oxycontin, Vicodin, and Fentanyl are frequently given to patients with terminal cancer, post operative pain, and chronic, persistent pain caused by any number of ailments.

Opioids have proven incredibly effective in the management of both acute and chronic pain. As a result of the compelling evidence seen in opioidal treatment, it is no wonder then why these drugs are not only frequently used, but misused and abused. Once healthy patients who have experienced pain for long periods of time, often struggle not only with the pain itself, but self perception and the limited ability to function in a world where they were once unencumbered. Opioids once provided for physical pain relief, then become the antidote for their emotional pain, too.

The Opioid Crisis and Pain Management

Throughout the world, the use of opioids has increased exponentially. Once utilized solely as an effective painkiller, it is now seen as a threat to public safety and welfare, as well as the reputations and licenses of the doctors who prescribe them.

The mishandling of opioids has become so dangerous, that it has lead many to addiction, criminal activity, and convictions. The American Academy of Family Physicians (AAFP) has dedicated themselves to finding a balance between the proper use of opioids while being mindful of the inherent risks these drugs hold. They recognize that pain relief is a necessary component of healthcare, do not want to limit their use by those who use them as prescribed, but understand that their potency is a very double edged sword.

Achieving Effective and Safe Management of Pain

The goals of pain management include an abatement of symptoms, increased comfort, enhanced physical, mental, and emotional functioning, and satisfaction with one’s pain regimen. Dr. Shahen Kurestian, DC of Body Systems and Wellness in Glendale, California is an excellent resource for pain management conducted in accordance with what you need. Dr. Kurestian supports the use of medicinal as well as non medicinal pain relief, with the end goal being optimal pain management that is safe, effective, and informed.

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