Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Ask your physician tough questions about opioids

Anita Gupta, DO, PharmD
Meds
July 3, 2017
Share
Tweet
Share

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Alleviating pain has been a primary focus of my career as a physician anesthesiologist. Just as there are physicians who specialize in treating conditions such as cancer, heart disease or allergies, there are specialists in treating pain. These physicians complete four years of medical school and further training in a specialty, such as anesthesiology, physical medicine, and rehabilitation, psychiatry or neurology, followed by an additional year of training to become an expert in chronic pain.

Every day on news outlets throughout the country we see stories about the risks and dangers of opioids. More than 300 million opioid prescriptions are written each year. Many people feel conflicted about taking them and pain medicine specialists throughout the country are working to help patients in pain use a wider variety of medications and therapies to effectively ease pain. For many patients, who have long-term or chronic pain, I suggest they ask their pain medicine specialist some tough questions about the risks and side effects of taking opioids.

One of my patients, Kathleen Callahan understands the dilemma of taking opioids long term. She suffers from a chronic condition that causes painful cysts, which required multiple surgeries resulting in post- surgical and chronic pain for which she took opioids for years. Being on a high dose of opioids, Kathleen developed a tolerance to the medication and still had chronic pain. So she turned to me to work with her to find an alternative.

For Kathleen, a mother of two who works in finance, opioids were a valuable tool for post-op recovery and acute pain, but when she was on them long-term, she couldn’t function and wasn’t enjoying life. She wasn’t as involved in her children’s lives, and her work was suffering. I worked with Kathleen to help her manage her pain, so her life became positive and livable. We weaned her off all medication except for occasional ibuprofen for bad days. Now she goes to the gym, goes out with friends and enjoys life by going to her son’s baseball games and her daughter’s school plays.

Kathleen and I had a few difficult discussions. There were a number of red flags that concerned me such as missed appointments and pharmacists calling about prescriptions. I didn’t think opioids were right for her anymore and I was truthful with her. Having these difficult conversations really developed trust between us, so I could help her move forward and cope with her pain. Since she’s been opioid-free, she’s vibrant and energetic again and is back to being successful in her career. She has her life back.

If you are taking opioids or your physician has prescribed them, as a pain medicine specialist, I suggest asking yourself (and your physician) some tough questions:

Why was I prescribed opioids?

  • Some physicians assume patients will demand what many consider the strongest and most effective pain relief and therefore prescribe opioids automatically. But there are many medication and non-medication options, so ask your physician if other pain relief methods might be effective.
  • If you and your physician decide opioids are the best option, ask how long you should take them. In most cases, opioids are most beneficial for short-term moderate to severe pain – such as a few days after surgery or an injury. If you continue to have pain, ask your physician about alternatives.

Are opioids affecting my quality of life?

  • Opioids have many side effects, ranging from severe constipation, mental fogginess and nausea to depression. Kathleen said she was “exhausted, cranky, depressed, constipated and gaining weight on opioids.” The opioids affected her relationship with her kids because she wasn’t as involved in their lives. That’s when she realized opioids were worse than the pain itself, motivating her to seek other options.

What should be my concerns about taking opioids – or stopping them?

With the media attention surrounding opioid risks, many people feel conflicted about taking them. They may:

  • worry they are being judged by others;
  • worry about developing a dependence or addiction and/or potentially overdosing; and
  • fear they won’t be able to control their pain if they stop taking opioids.

It’s important to talk to your physician if you have these concerns or others. It’s also important to ask about getting naloxone, a drug that reverses overdoses, if injected quickly enough.

Is it time to consider other methods of pain management?

Opioids are most effective in the short-term. While some people with chronic pain find relief with opioids, they should be part of a “multimodal” plan, which features other methods of pain management. Discuss alternative therapies with your physician, including:

ADVERTISEMENT

  • Injections or nerve blocks. Injection with local anesthetics can short circuit muscle and nerve pain.
  • Electrical stimulation and spinal cord stimulation. Electrical impulses sent by devices that are implanted or worn on the body can block pain.
  • Physical therapy.  Strengthening muscles can improve function and decrease pain. Physical therapy may include other pain-easing methods such as whirlpools, ultrasound and massage.
  • Acupuncture. Very thin needles placed in various parts of the body can interrupt pain signals.
  • Biofeedback, meditation, deep breathing and relaxation. These methods can ease pain by controlling involuntary functions such as heart rate, as well as learning to ease muscle tension.
  • Surgical procedures. In some cases, surgery can correct painful abnormalities or sever the nerves causing the pain.

These are the difficult questions that people like to avoid, but physicians and patients need to talk so the patient can get the most appropriate treatment. With all the tools we have, there is a lot more patients can do for their pain with their physician’s help. Kathleen’s entire outlook on pain management changed after a few difficult conversations with me. She has said, if she didn’t have a physician anesthesiologist on her medical team, she thinks today she would be very overweight, inactive, not part of her children’s lives and clinically depressed. She has described the difference in her life without opioids as the difference between night and day. Check with your pain medicine specialist, have those difficult conversations and see if you can find a better solution to your chronic pain.

Anita Gupta is an anesthesiologist.

Image credit: Shutterstock.com

Prev

The 3 phases of a physician's career transition

July 3, 2017 Kevin 1
…
Next

A wealth of medical knowledge in a country that lacks resources

July 3, 2017 Kevin 0
…

Tagged as: Pain Management

Post navigation

< Previous Post
The 3 phases of a physician's career transition
Next Post >
A wealth of medical knowledge in a country that lacks resources

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Anita Gupta, DO, PharmD

  • 3 solutions to combat rising drug overdoses during COVID-19

    Anita Gupta, DO, PharmD
  • How physicians can curb the prescription opioid epidemic

    Anita Gupta, DO, PharmD
  • a desk with keyboard and ipad with the kevinmd logo

    Have a safer hospital stay: Use a checklist

    Anita Gupta, DO, PharmD

Related Posts

  • Why staying ahead of your pain with opioids is the wrong advice

    Myles Gart, MD
  • Blame the pain, not the opioids

    Angelika Byczkowski
  • A physician’s addiction to social media

    Amanda Xi, MD
  • Want to stop the opioid epidemic? Stop prescribing opioids.

    Jenny Hartsock, MD
  • A paradigm shift in acute pain assessment and management

    Myles Gart, MD
  • Physicians are being murdered for not prescribing opioids

    Jessica Jameson, MD

More in Meds

  • Why retail pharmacies are the future of diverse clinical trials

    Shelli Pavone
  • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

    Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO
  • A world without antidepressants: What could possibly go wrong?

    Tomi Mitchell, MD
  • The truth about GLP-1 medications for weight loss: What every patient should know

    Nisha Kuruvadi, DO
  • The hidden bias in how we treat chronic pain

    Richard A. Lawhern, PhD
  • Biologics are not small molecules: the case for pre-allergy testing in an era of immune-based therapies

    Robert Trent
  • Most Popular

  • Past Week

    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • Why male fertility needs to be part of every health conversation

      Hoag Memorial Hospital Presbyterian | Conditions
    • How home-based AI can reduce health inequities in underserved communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Inside human trafficking: a guide to recognizing and preventing it [PODCAST]

      The Podcast by KevinMD | Podcast
    • Graduating from medical school without family: a story of strength and survival

      Anonymous | Education
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
  • Recent Posts

    • How home-based AI can reduce health inequities in underserved communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Adriana Smith’s story: a medical tragedy under heartbeat laws

      Nicole M. King, MD | Physician
    • What if medicine had an exit interview?

      Lynn McComas, DNP, ANP-C | Conditions
    • Why U.S. health care pricing is so confusing—and how to fix it

      Ashish Mandavia, MD | Physician
    • From survival to sovereignty: What 35 years in the ER taught me about identity, mortality, and redemption

      Kenneth Ro, MD | Physician
    • When doctors forget how to examine: the danger of lost clinical skills

      Mike Stillman, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 18 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • Why male fertility needs to be part of every health conversation

      Hoag Memorial Hospital Presbyterian | Conditions
    • How home-based AI can reduce health inequities in underserved communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Inside human trafficking: a guide to recognizing and preventing it [PODCAST]

      The Podcast by KevinMD | Podcast
    • Graduating from medical school without family: a story of strength and survival

      Anonymous | Education
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
  • Recent Posts

    • How home-based AI can reduce health inequities in underserved communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Adriana Smith’s story: a medical tragedy under heartbeat laws

      Nicole M. King, MD | Physician
    • What if medicine had an exit interview?

      Lynn McComas, DNP, ANP-C | Conditions
    • Why U.S. health care pricing is so confusing—and how to fix it

      Ashish Mandavia, MD | Physician
    • From survival to sovereignty: What 35 years in the ER taught me about identity, mortality, and redemption

      Kenneth Ro, MD | Physician
    • When doctors forget how to examine: the danger of lost clinical skills

      Mike Stillman, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Ask your physician tough questions about opioids
18 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...