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an honest conversation about opioid addiction

An Honest Discussion On Opioids

by Brian Whittington, PT, DPT, CMTPTLeave a Comment

Randy Ramseyer pleads with the head of the District Attorney’s office to take his concerns seriously. Ramseyer and his partner are Virginia lawyers following an alarming trend. Nearly all of their cases are connected to OxyContin. Ramseyer doesn’t fully realize the scope of this problem, but in a clear, confident voice, he says, “Our community is ground zero for a national catastrophe!”

This catastrophe became commonly known as the “opioid epidemic” and this dramatic scene was captured in the hit Hulu show Dopesick. Dopesick, an 8-part mini-series starring Michael Keaton, captures its audience by exposing the underbelly of the opioid epidemic. Yet the series’ most important contribution was to capture how the opioid epidemic affected real people, families, and countless communities around the country.

Projects like Dopesick have helped bring awareness to the opioid epidemic, but there’s still a lot of work to be done. Some of that work starts with having honest discussions about opioids.

Opioids 101

Opioids, also referred to as narcotics or painkillers, are naturally occurring substances extracted from the opium poppy plant. These drugs gained popularity in the 90’s and early 2000’s to treat moderate-to-severe pain from injuries, surgeries, and chronic pain.

It can be helpful to think of opioids in three categories as each type contributes uniquely to the epidemic. While there are naturally derived drugs like OxyContin, Vicodin, Percocet, and Morphine, there’s a second type, synthetic drugs like Fentanyl, that have been created in labs. Both natural and synthetic opioids are developed into prescription medications, but illegal drugs like heroin are not. Despite drastically different ways these drugs were distributed, the opioid epidemic was fueled by both prescription and illegal opioids.

You might be wondering why we even use opioids. Well, opioids were and still are found medically useful for their pain-relieving ability. Opioids work on receptors in the brain and nervous system to regulate signals coming from the body that the brain interprets as pain. In doing so, opioids can provide pain relief. The problem is, like some good things, there’s a double edge sword. Opioids also cause a large release of dopamine in the brain, a substance that creates a feeling of pleasure. This feeling can give the user a “high.” Over time, the body requires higher drug doses to elicit similar effects.1

The Opioid Epidemic

The increasing dependency on the drug, along with the ease of access to prescriptions in homes and illegal opioid use, created an opioid firestorm that ravaged the nation by experiencing overdose deaths in 3 distinct waves.

The first wave began in the late 90s with the initial increased prescribing of opioids. The second and third waves, which began around 2010 and 2013, saw overdoses of heroin and synthetic opioids, respectively. These waves created a tsunami of overdose deaths between 1999 and 2019, when nearly 500,000 people died from all types of opioids.2 Tragically, 136 people still die each day from opioid overdose.3

Right Problem Wrong Solution

Grasping the scope of the opioid epidemic is vital, but we must avoid a certain danger. We must be careful not to overcorrect and dismiss people’s pain while we critique past failed solutions for it. 50 million Americans live with chronic pain , and another 126 million adults report experiencing some pain within the last 3 months.4,5 If the pain gets dismissed because of opioids, we compound the problem and ultimately cause more harm.

With increasing urgency, we need to look for alternative means to treat people’s pain. Instead of opioids, we can turn to alternatives like physical therapy, which has been shown to be an effective means of treating pain.

Physical therapists are experts in treating acute and chronic pain, which has led to innovative ways of treating pain, like providing physical therapy treatments in emergency medicine departments. Instead of leaving the ER with only prescription medication, the patient will have already received therapy treatment and have a prescription for continued services.

Physical therapy is also an excellent choice to treat pain as it can address the entire spectrum of influencing pain factors. Pain science research has shown that pain is not strictly biological phenomenon but includes biopsychosocial factors.6 Opioids only influence the biological, which often leads to missing other crucial factors that contribute to a patient’s pain experience. Physical therapists can then treat, monitor, or refer a patient out for biological, psychological, or social factors, that may influence the patient’s pain.

Athletico’s Commitment

As an industry leader, Athletico takes seriously the role that physical therapy plays in combating the opioid crisis. As part of Athletico’s commitment to combating the opioid crisis, we have partnered with the SAFE Project, a non-profit organization dedicated to ending the addiction epidemic. Many Athletico employees have joined the “No Shame Movement,” which looks to destigmatize mental health and addiction, making it easier for people to seek the help they need. Practically, Athletico is committed to training all clinicians in Pain Neuroscience (PNE), a tool used to help treat the full scope of patients’ pain.

If you are having pain, you can schedule a free assessment today! Free assessments are available in clinics or virtually through our telehealth platform.

Request a Free Assessment

*Per federal guidelines, beneficiaries of plans such as Medicare, Medicaid, Tricare, VHA and other federally funded plans are not eligible for free assessments.

The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

References:
1. https://nida.nih.gov/publications/drugfacts/prescription-opioids
2. https://www.cdc.gov/drugoverdose/epidemic/index.html
3. https://www.safeproject.us/
4. https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm#:~:text=An%20estimated%2020.4%
5. https://www.nih.gov/news-events/news-releases/nih-analysis-shows-americans-are-pain#:~:text=It%20found%20that%20an%20estimated,experience%20severe%20levels%20of%20pain.
6. Louw A, Farrell K, Choffin B, Foster B, Lunde G, Snodgrass M, Sweet R, Weitzel M, Wilder R, Puentedura EJ. Immediate effect of pain neuroscience education for recent onset low back pain: an exploratory single arm trial. J Man Manip Ther. 2019 Dec;27(5):267-276. doi: 10.1080/10669817.2019.1624006. Epub 2019 Jun 4. PMID: 31161919; PMCID: PMC6830205.

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About the Author:
Brian Whittington is a physical therapist and regional director for Athletico. Brian is particularly interested in treating knee and shoulder injuries and specializes in post-operative ACL reconstruction rehabilitation. Brian's treatment focus also includes the growing patient population dealing with chronic pain. His practice philosophy is not limited to injury recovery but includes education for injury prevention and general health and wellness. Brian's mission is simple, keeping people moving so they can live optimally healthy lives.

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