Why Using Opioids to Treat Chronic Pain Is Problematic and What You Can Do Instead

It is always a treat to have guest writers at Hearing Elmo. Today, we welcome Jackie Waters. Jackie is a mother, a homemaker, and a farmer who lives with her family on their farm in Oregon. She is passionate about providing a healthy and happy home for her family and aims to provide advice for others on how to do the same with her site  Hyper-Tidy.com.

As a country, we are consuming more prescription opioids than ever before. We are the leading opioid-using nation in the world. The opioid epidemic has reached a point where doctors are beginning to totally rethink the way they prescribe, and this directly affects chronic pain patients. This is all with good reason, however. Using opioids to treat chronic pain can be problematic.

The difference between acute and chronic pain

“Acute pain, if you will, is a bit of a no-brainer. Pain is a message that damage is occurring to our body, and we need to take action. From a medical perspective the physiology of acute pain is well understood; it’s associated with tissue damage and resolution of the pain is associated with healing of the injury,” says physician Gary Kaplan.

Chronic pain is much more complicated. We are often unable to pinpoint the exact causes of chronic pain, as all the signs associated with acute pain have long since dissipated. Chronic pain can involve a multitude of complex issues, including mental ones, and can affect multiple areas and systems of the body. Long story short, it’s hard to pinpoint.

While using opioids to treat acute pain is simple and relatively harmless, the use of opioids to treat chronic pain is problematic. Long terms use of opioids can have devastating physical and mental health effects.

Chronic pain sufferers can develop a dependency to opioids

Even when taken as prescribed, opioids are highly habit-forming. Many chronic pain sufferers misuse the drugs, however, and take them in ways that are more harmful than their normal administration (snorting, more frequent use, higher dosage).

One of the main problems with taking opioids for a long period of time is that they become less effective over time. This forces people to continue upping their dose, which leads to addiction.

“A property of opioid drugs is their tendency, when used repeatedly over time, to induce tolerance. Tolerance occurs when the person no longer responds to the drug as strongly as he or she did at first, thus necessitating a higher dose to achieve the same effect,” says DrugAbuse.gov.

How to manage chronic pain without opioids

Your ultimate goal may be to eliminate the use of prescription drugs altogether, but it’s important to know that any reduction on the use of opioids is beneficial to your health. In order to do this, however, you have to have alternative methods to manage your chronic pain.

For temporary relief of chronic pain, many sufferers turn to acupuncture, massage, hydrotherapy, and chiropractic care. All of these can work, but all do not work for everyone. You must find the type of acute care that best helps your specific type of chronic pain.

For more sustained relief, some lifestyle changes must be considered. If you are overweight or obese, this is likely the leading exacerbating factor of your chronic pain. Losing weight reduces stress on the bones, joints, and muscles. Adopting a healthier diet is probably the best long-term strategy for managing chronic pain.

Apart from that, exercise is your next best option. You might be wary to dive into an exercise regimen for fear that it will make your chronic pain worse, but in fact it’s just the opposite. Check here for five great exercises for chronic pain.

Short-term use of opioids to treat pain is not necessarily a bad thing – in fact, it’s a widely accepted medical practice. Problems arise, however, when people start to rely on prescription drugs to help them cope with long-term pain.

Photo Credit: Pixabay.com

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Why I Rarely Vent (in Person)

My head is gonna explode. There's a reason I don't vent in person...
My head is gonna explode. There’s a reason I don’t vent in person…

Aren’t I brave to post a picture with no make-up on a “horrible, rotten, no-good day”? I decided last minute to stop in at work on Monday to check my mail box. I forget to do it during the summer when I’m not teaching. Anyway, I ran into a person I know fairly well. I almost ran the other direction because I know her well enough that I didn’t want her to see me with no make-up, flip-flops, and blue jeans. However, since SHE had all that going on too… I decided to let her flag me down instead of pretending I didn’t see her. We exchanged the “how’s your summer going?” questions and visited for a few minutes. We’ve served on various committees together and so when she asked me, “So how are you really doing?” I didn’t hesitate to answer truthfully. Silly me, I thought she wanted to know!

Well, I have had a bad day. I get super tired of falling on rainy days. Ya know? But the weather for the rest of the week looks great” and I beamed my best smile!

She said (I kid you not), “Yeah, I fell this weekend and broke my friggin’ nail. Just look!” (she sticks her finger in my face for easier viewing). “I just got a manicure too!

Now the first thing that popped into my head wasn’t nice. So I’m not even going to repeat it on here. My second thought, however, was “this is why I’m not honest to people face-to-face“. Besides… if you don’t live with a chronic illness or disability, you just can’t understand what having a bad day for THAT person really means. (I can’t completely understand YOUR bad day either). It’s not their fault. I chose to believe she was trying to commiserate and help in some way. I “ooo’d and aaaah’d” over her broken, manicured nail, getting madder and madder (but doing a fantastic job of hiding it, I might add!)

After due diligence in bemoaning her broken nail, I turned to leave. Since I had been holding her wrist to get a better look at the nail, I dropped my hand (and her hand) as I turned to walk away. It was then she noticed my arm. “Oh my gosh. What did you do to your arm?

I turned my arm to look at where she was looking and saw a row of purple and blue bruises. “Oh that,” I said breezily, “yeah, I said I fell, right?” Her eyes got really big, and she whooshed out on an astonished breath, “Well, I’m an ASS, aren’t I?

I giggled. Not at her.

Ok, yes it was AT her, but her self-condemnation and horrified look were truly priceless. I assured her that all was well, working hard to make sure we went our separate ways with friendship and her self-esteem still intact. After all, I didn’t want her to think that *I* thought she was an a**. Even though I did…

Why We Dodge the “HOW ARE YOU?”

On the short drive home I belly-ached out loud to Milo (new Service Dog). One of the great things about service dogs is their non-judgmental, listening ears. When I’m angry, I tend to cry. Not sad tears either. (Hubby has learned to not “there-there” me when he sees tears because chances are he’s in trouble and not that I’m sad and need a shoulder).

Many people with chronic illness and disabilities lie. Not premeditated lying. It’s more of a self-protective omission of the truth. When your NORMAL is not “normal” for people who do not live with significant health challenges, you do not really have symptom-free days. Instead, you learn to appreciate the good days and try super hard not to dwell on the bad days. You don’t ever answer “how are you?” truthfully. (Unless the person who asks lives it too and really gets it). You don’t want to be a negative Nellie; a sour puss; a stick in the mud; __________________ (fill in the blank).

So you dodge the question, or flat out lie. I had a friend tell me that “stating how my day really is going doesn’t make my day better. It only depresses the other person. Since there isn’t anything they can really DO to make it better, I grab FRIENDSHIP by the collar and don’t let go, insisting my day is going very well if only to talk to a friendly face for a few moments longer”.

Don’t get me wrong… we all need some folks we can be honest with and tell it like it is. For me, it is often God because I figure His shoulders are broad enough. Sometimes I need a flesh-and-blood human face to talk, too. This is why I highly recommend support groups. I rely on the people I have come to know at Fidos For Freedom. We couldn’t be any more different. We struggle with completely different kinds of disabilities and challenges, but each one of us understands why we dread the “how are you?” question. Even virtual support (through the medium of the Internet) can be very therapeutic to people with chronic illness and disabilities.

But… I really want to know! I really want to help!

I have a few people in my life (and I hope that you do, too) who I can be honest with  when I’m overwhelmed with a “horrible, rotten, no-good day”. They may ask, “how are you really doing?” and I TELL them. The obvious next question is, “Well, what can I do to help?” Ya know? I’ve really wanted to take people up on this before. I mean… sometimes it may be that I need someone to go shopping with me. Milo is terrific, but there are some things he cannot pick up and some things I really wish I hadn’t dropped to start with! (like glass). Shopping is exhausting for me but a necessary chore.

My son has a “temporary disability” as he fell through the ceiling while in the attic and broke his arm. (The full story is much longer, but I’m not going there today). He is really struggling with doing “normal” things because he has one hand. So I asked him, “what can I do to help?”

Laundry. My son asked me to do his laundry! And do you know, I was almost hysterical with JOY? I love to do laundry! I am ABLE to do laundry! I love pre-treating stains, choosing settings on the washer, and piling things in evenly. I love putting wet clothes into the dryer. And… (OMGosh I’m trembling with excitement I can hardly get it out…) I love folding warm clothes from the dryer. I’m getting goosebumps thinking about the neatly folded piles of “like” clothing. It’s a very normal (and for most people), boring task. However, “son” couldn’t do it. *I* could help.

If you are in a position to help someone who lives with chronic illness, doing something rather ordinary — is EXTRAORDINARY for them.

Loading/unloading the dishwasher

Washing the bedding and re-making the bed

Mowing the lawn

Deep-cleaning a bathroom

I know people with various disabilities who do things to help out others with disabilities. That’s how it should be, right? People… just helping PEOPLE.

Concluding full circle here – VENTING

I have some high maintenance friends. And you know something? I love them. I knew in advance they were high maintenance and I chose to be their friend anyway. I also have some friends who “hold their hand close to their chest”. Heck, if I’m really going to see their “hand”, I almost have to yank them towards me and demand “a real reveal”. I’ve had to learn how to “read” them. I very well may MISS IT sometimes – the clues that tell me that all is not well.

Sometimes people just need to vent. They KNOW you can’t do anything to improve their situation. They KNOW they will have better days (so please? Don’t tell them, “the sun will come out tomorrow”?) They may just need a few moments to tell you like it really is. You say, “How are you?” and they decide to open the dam. It may pour out of them. It may be a trickle of water that you have to give additional encouragement to in order to really break down that barrier.

Let them VENT.

… and then what? I don’t recommend patting them on the shoulder and asking if they feel better. What’s the next step?

It’s two years old now, but I love — absolutely LOVE this advice. <Click here for full article> The highlights and three follow-up (recommended) questions to a “Vent-or” are:

  1. What bothers you the most about the situation?
  2. What is making you the most _______________?
  3. (My favorite) What worries you about this?

This is listening done right. They vent. You follow-up with questions that let them know you were actually listening. You can brain-storm with them options that may help them with some of the things that are frustrating them. You may discover through dialoguing with them, a way that you can easily help them beyond providing a listening ear.

Folks who live with disabilities or chronic illness like being able to reciprocate, too. I am on CLOUD NINE that my son needs me to do his laundry for him right now. I love dog-sitting for my daughter’s dog when she needs to go out of town. There are some things I can do. Let me do them. 🙂

I hope you will look at venting a little differently after reading this. Especially if the venting you listen to is from someone who has significant health challenges. One of my dear friends has a seizure disorder as well as other significant health challenges. She often lets me hear how things are really going because she knows I care. I tell her I will be praying, and she knows I mean it. She immediately asks, “so how can I pray for YOU?” and I know she means it. A praying friend can be HUGE. Sometimes you can do more. I hope you will look for those opportunities. Lysa TerKeurst does a great job blogging about this. Please allow me to share her great article with you: “Don’t Say You’ll Pray for Me“.

Denise Portis

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