Opioids are one of the most commonly
prescribed painkillers.
From broken ribs to back pain
to treating pain after surgery.
But there's a lot
of misconceptions around them,
so it's important to take the time
to understand them better.
[Body Stuff with Dr. Jen Gunter]
The first misconception
is that opioids are the best,
strongest form of pain medication.
But in almost every well-designed study
comparing opioids to anti-inflammatory
drugs such as ibuprofen,
the anti-inflammatories come out on top.
From a safety or effectiveness
perspective, or both.
Let's talk about the effectiveness first.
How do opioids work?
To understand that, we have to first know
a little bit about how pain works.
Pain is our body's way of telling us
that something's wrong.
You stubbed your toe,
you burned your hand.
Pain gives us the message
that it's time for us to rest,
recover and treat the damage.
In the body, pain is created by multiple
chemical signals and receptors,
and different medications can target
different parts of that pain pathway.
Medications like acetaminophen,
such as Tylenol,
or nonsteroidal anti-inflammatory drugs,
also known as NSAIDs, like ibuprofen,
aspirin and naproxen,
all treat pain in different
ways from opioids.
Opioids work by binding to
and activating the opioid receptors
located throughout the body,
blocking pain signals.
This activation also triggers
the release of dopamine,
a hormone associated with pleasure.
So in addition to pain relief,
some people can feel relaxed
or even euphoric.
In higher doses, opioids can affect
cognition and even breathing.
But here's a really important point
that people often don't know.
Opioid receptors can adapt,
often in a short amount of time,
to expect opioids.
And when a patient doesn’t take them,
they experience symptoms of withdrawal.
And withdrawal is very uncomfortable.
People can mistake that discomfort
for thinking the opioids
were actually working.
And what people don't know
is this can happen after just a few doses.
When you're a patient
needing relief from pain,
it can be confusing
to know the difference.
All you want is to feel normal again.
In this way, opioids, if not used
very carefully and intentionally,
can create physical dependence.
They can also paradoxically worsen pain.
And there's a risk
of developing addiction.
There's nuance here.
People who have become
physically dependent
often don't even know they are.
They just know that the opioids
seem to be offering relief
without realizing that they could actually
be contributing to the pain.
I want to be clear here.
Opioids can be effective,
appropriate therapy,
but they should be prescribed
with great care.
This is the doctor's responsibility.
Here's some advice
so you can be an educated patient.
If you or a loved one
experience acute pain,
ask to explore alternatives
to opioids like Tylenol,
NSAIDs, muscle relaxants
and physical therapy.
If your doctor
doesn’t bring those up first,
and if you or a loved one
are prescribed opioids,
make sure your doctor has a plan
to taper you off,
accounting for the risk of dependence.
And finally, ask for naloxone.
This is a drug that can reverse
opioid overdose.
It can be easy to forget
if you’ve taken a dose,
and you never know who in your household
could take your medication.
Naloxone can literally save a life.
Remember, when it comes to pain,
opioids are not always the most effective
way to safely offer relief.
And when they are prescribed,
they should always
be prescribed with a plan.