Types of Non-Opioids for Pain Relief

Opioids are a type of pain-reliever made from the opium poppy plant that prevent pain signals from reaching the brain. They are frequently prescribed for chronic pain. While they are effective, these drugs are highly addictive.

There is an opioid epidemic in the United States. According to the Health Resources and Services Administration (HRSA), opioid-related overdoses cause more than 130 deaths every day. Fortunately, there are non-opioid alternatives that are effective for managing chronic pain.

This article discusses chronic pain, opioid use, and alternative treatments.

The Multifaceted Problem With Chronic Pain

Chronic pain is very common and treatment can be challenging. Here are several reasons why.

It Affects Millions of Americans

Pain becomes chronic when it lasts for several months or more. Chronic pain is very common. In fact, as of 2019, more than 20% of the adult population in the United States had chronic pain. It often interferes with daily activities and affects a person's ability to work.

According to the Centers for Disease Control and Prevention (CDC) 2019 National Health Information Survey, chronic pain affected women more often than men, becoming more common as people aged. About 30% of people with chronic pain were age 65 or older, and it occurred most frequently in the non-Hispanic White population.

It Can Be Hard to Treat

According to the CDC, about 20% of people who see a healthcare provider for pain will receive a prescription for opioid medication.

People who manage their chronic pain by avoiding physical activity and taking medications have been shown to have double the amount of disability than people who still exercise and try to keep a positive mindset.

Commonly prescribed opioids include:

• Roxicodone (Oxycodone)
• Fentanyl
• Hydrocodone
• MS Contin (Morphine)
• Oxymorphone
• Belbuca (Buprenorphine)
• Codeine

Opioids Have a Temporary Effect

Opioids temporarily relieve pain but also produce a sense of euphoria. These drugs stimulate the pleasure centers in the brain. When opioids are used repeatedly, such as for chronic pain, the brain builds up a tolerance to the drug and higher doses are needed to have the same effects.

Long-term use of opioids slows the brain's production of pleasure chemicals.

When opioid use is stopped, it can lead to withdrawal symptoms, including anxiety, tremors, diarrhea, and muscle cramps. People may then continue to take the drugs to avoid these negative side effects. This leads to a vicious cycle.

Alternatives to Opioids

Non-opioid medications, therapies, and lifestyle behaviors can effectively help manage chronic pain.

Non-Opioid Medications

A variety of non-opioid medications are used to treat chronic pain. Although these medications are generally safer than opioids, they are not entirely without potential side effects.

Examples include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve (naproxen) and Advil/Motrin (ibuprofen)
• Tylenol (acetaminophen)
• COX-2 inhibitors
• Certain antidepressants, including tricyclics, and serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Anticonvulsants, such as Neurontin (gabapentin) and Lyrica (pregabalin)

Physical Therapy

Physical therapy is an effective treatment for chronic pain. In addition, physical therapy can help restore function that has been lost or negatively impacted by pain.

Physical therapy interventions for pain include:

• Heat or cold modalities (heating pad, ice pack)
• Ultrasound (heats soft tissues in the body)
• Electrical stimulation (can decrease pain and inflammation, increase circulation, and help with muscle contraction)
• Dry needling (helps relieve muscular pain and improve joint range of motion)
  
• Functional mobility training (helps train muscle groups make proper movements)
• Adaptive equipment (such as a cane or walker)
• Massage
• Exercise

Complementary Treatments

A variety of alternative pain management treatments can also help treat chronic pain. These include:

• Acupuncture
• Meditation
• Yoga
• Tai chi
• Spinal manipulation
• Hypnosis
• Massage
• Biofeedback
• Relaxation techniques
• Qigong
• Exercise

Chronic Pain and Mental Health

In addition to physical symptoms, chronic pain has a big impact on mental health. It is estimated that up to 50% of people with chronic pain also have depression. Chronic pain can also lead to feelings of hopelessness and poor quality of life.

Psychotherapy (talk therapy) provides support for people living with chronic pain by addressing the way pain affects every aspect of a person's life.

One type of psychotherapy used to support people with chronic pain is acceptance and commitment therapy (ACT). This approach helps individuals learn to accept that pain (and other negative experiences and emotions) are part of life—not something that needs to be suppressed or that can be eliminated.

ACT also focuses on committing to activities that contribute to life in a positive way, such as through relationships, personal growth, and job duties, despite living with chronic pain.

Tips for Living With Chronic Pain

Follow these tips to improve quality of life with chronic pain:

• Avoid negative self-talk.
• Stay active.
• Don't isolate yourself.
• Explore hobbies.
• Eat a healthy diet.
• Get adequate sleep.
• Practice stress management techniques.

Summary

Opioids are commonly prescribed medications to treat chronic pain. These drugs are highly addictive, and overprescription and misuse of these medications has led to an opioid crisis in the United States.

A variety of alternative treatments are available for chronic pain, such as non-opioid medications, physical therapy, acupuncture, yoga, massage, exercise, and biofeedback. Psychotherapy also helps treat the mental challenges and stress that often occur with chronic pain.

A Word From Verywell

Chronic pain can affect every aspect of your life. The best treatments address the physical, emotional, social, and psychological components of this condition. Talk to your healthcare provider about options other than opioid medications. For additional support, consider joining a chronic pain support group.

If you suspect that you might have an opioid addiction, talk to your healthcare provide or contact the Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline at 800-662- HELP (4357).