Pain is associated with unpleasant physical sensations that can lead to mental distress or agony in extreme cases. For those who serve or have served with the U.S. military forces or any other defense service, pain may be the result of physical or mental wounds inflicted during the service. And routine deployments may make the pain unbearable and torturous.
Prescribing opioids for pain is a common practice among medical practitioners. However, the practitioners fail to realize that regular opioid use can increase the risk for overdose and addiction to the painkillers. The Department of Veterans Affairs (VA) and the Department of Defense (DoD) have suggested a slew of clinical practice guidelines concerning opioid use for treatment of long-term and critical pain.
Guidelines for safe pain treatment
Stressing on the aim to enable health care providers to manage all the aspects of patient care – diagnosis, treatment and follow-up – the work group said, “The system-wide goal of this guideline is to improve the patient’s health and well-being by providing evidence-based guidance to providers who are taking care of patients on or being considered for long-term opioid therapy.”
The guidelines, advanced by the Opioid Therapy for Chronic Pain Work Group, include:
- It urged experts to abstain from advising prolonged opioid therapy for chronic pain. It stressed on alternative procedures to opioid therapy like self-management programs and non-pharmacologic methods. Pharmacologic treatment must stress on interventions sans opioids.
- Opioid therapy must not exceed three months because short duration of treatment would help prevent addiction possibilities. It emphasized on the need to re-evaluate risks and benefits and discuss the same with patients while allowing them to choose opioid therapy over other means.
- It suggested the need to adopt strategies to combat risks of opioid dependence along with conducting regular examination for any kind of opioid use disorder.
- Patients must be screened for problems akin to untreated substance use disorder (SUD) before prescribing prolonged opioid therapy. If the patient suffered from SUD, a detailed observation and treatment for patient will be suggested before prescribing opioids.
- Comorbid use of benzodiazepines and prescription medicines must be discontinued.
- Refrain from advising opioids for prolonged periods to patients below 30 years and suffering from acute pain due to overdose and addiction risk.
- Apply risk reduction methods after starting prolonged opioid treatment. The therapy procedure must commence with an informed consent including the dangers and advantages of opioid therapy apart from other existing non-pharmacological interventions. The programs planned and implemented along with their recurrence must be in accordance with the risk factors involved and must include arbitrary urine drug testing, logging into state prescription drug monitoring programs, checking for possibilities of overdose and suicidal tendencies, necessary education about overdose problems and the risks involved apart from naloxone use to prevent overdose patients from collapsing.
- Evaluate risk of suicide while beginning or continuing prolonged opioid therapy.
- Assess benefits of continued opioid treatment and associated risks linked to opioid overdose every three months.
- Clinicians should advise the lowest possible dose of opioids as there is nothing like safe dosage of opioids. Opioid equivalent to over 90 mg morphine must be avoided daily.
- Customize reduction in opioid prescription on the basis of risk evaluation and patient needs.
- Utilize interdisciplinary care for pain treatment, substance use disorders and mental illnesses among patients exhibiting unusual behavior.
- For pain ranging from mild to severe, holistic measures, including multimodal pain care like prescription of non-opioids, was advised. In case of prescription of take-home opioids, the VA and DoD advised prescription of immediate-release opioids at the lowest effective dosage.
Recovery road map
According to the National Center for Complementary and Integrative Health (NCCIH), roughly 50 million American adults suffer from chronic pain at any given point of time. The Chronic Pain Program at Sovereign Health’s San Clemente facility conducts detailed evaluation before the treatment to understand the root cause of the pain. Patients are educated about non-pharmacologic measures to manage pain.
Chronic pain when gets unbearable can increase the chance of opioid overdose and addiction. This is a primary reason for pushing the country toward opioid epidemic. To avail the benefits of our innovative pain program, get in touch with Sovereign Health of California. Call at our 24/7 helpline number (866) 819-0427 or chat online to know about the most effective pain treatment facilities in California where the discomfort owing to pain is taken care without using pain relievers.
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