The opioid threat

You’ve no doubt heard of the opioid epidemic raging across the United States. But did you know that Nevada has been particularly hard hit with an average rate of 87.5 prescriptions per 100 residents, compared to 66 at the national level?

To help address the epidemic in Nevada, beginning January 1, 2018 Assembly Bill 474, known as the Controlled Substance Abuse Prevention Act, takes effect.

Sponsored by Governor Brian Sandoval, the bill mandates that doctors conduct mental health evaluations before prescribing painkillers like Oxy-Contin, Vicodin and fentanyl to patients for the first time. They are also required to limit initial painkiller prescriptions to 14-day supplies of no more than 90 morphine-milligram equivalents per days.

Prescribers are also required to inform new patients of the risks of dependency and overdose, as well as other ways to treat the patient’s pain.

The Problem with Opioids

Opioids are potent pain relievers that include oxycodone, hydrocodone, morphine and others. They are also heroin and fentanyl. They are extremely effective at fighting pain when used according to directions. One of the biggest problems, however, is that they trigger the brain to release dopamine, creating a sense of euphoria. When a user stops, a craving can kick in making it difficult to quit even when the original pain has gone away.

The other big problem, of course, is that people can die from the overuse of opioids. The Centers for Disease Control (CDC) reports that from 2000 to 2015, more than half a million people in the United States have died from opioid-related drug overdoses - 91 Americans die every day from opioid overdose

To prevent the misuse of opioids, the CDC recommends the following:

  • Never take opioids in greater amounts or more often than prescribed.
  • Never sell or share prescription opioids.
  • Store prescription opioids in a secure place, out of reach of others (including children, family, friends and visitors).
  • If you have unused prescription opioids at the end of your treatment, find your community drug take-back program or your pharmacy mail-back program.
  • Don’t take opioids with alcohol and other medications like:
  • Benzodiazepines (such as Xanax® and Valium®)
  • Muscle relaxants (such as Soma® or Flexeril®)
  • Hypnotics (such as Ambien® or Lunesta®)
  • Other prescription opioids

Be Cautious with Non-Prescription Medicine as Well

GBO’s Dr. Richard Mullins warns that over-the-counter medications like Tylenol can also be dangerous, particularly if you’re taking them without the advice of a medical professional.  

According to the Federal Drug Administration, Acetaminophen is safe when used according to the directions on its labeling, however, “Acetaminophen can cause serious liver damage if more than directed is used.” Acetaminophen is also found in Actifed, Alka-Seltzer Plus, Benadryl, Co-Gesic, Contac, Excedrin, Fioricet, Lortab, Midrin, Norco, Percocet, Robitussin, Sedapap, Sinutab, Sudafed, TheraFlu, Unisom PM Pain, Vick's Nyquil and DayQuil, Vicodin, and Zydone.

The U.S. National Library of Medicine National Institute of Health reports that: “Analysis of national databases show that acetaminophen-associated overdoses account for about 56,000 emergency room visits and 26,000 hospitalizations yearly.” And ProPublica reports that, “Between 2001 and 2010, more than 1,500 people in the U.S. died from accidental acetaminophen overdoses.”

Pain is a Natural Part of Life

“There’s this belief that we should all be completely pain-free and that’s not realistic,” Dr. Mullins shares. “If you’re over 50 or 60, you’re always going to feel something. The goal is to moderate the pain rather than expecting to get a pill to make it go away.”

Rather than addressing the source of the pain, Dr. Mullins says narcotics mask it.

“Stiffness is a big enemy as we get older, especially around our joints and muscles,” Dr. Mullins says. “Regular movement helps address that.”

For those with muscle, bone or joint issues, exercise comes with some caveats. To ensure health and safety, the guidance of a credentialed trainer is key. “There are those with deep experience and training in this kind of thing,” Dr. Mullins says. “And there are those who might be decent coaches, but they don’t know anything about injury prevention.”

While the trainer at your local gym may know how to help you increase your bench press, if you have joint issues, you need a specialist. Someone trained in injury prevention is better equipped to help you reach your goals safely with better long- term outcomes.

If you experience sharp or stabbing pain and it doesn’t go away after exercise, you may need to see a doctor. If you already have joint issues, visit an orthopedist when you experience discomfort. If you don’t have diagnosed joint issues, you’ll want to see your general practitioner to find out what’s going on. They’ll refer you to an orthopedist if necessary.

The Bottom Line

There are serious risks that go along with the use of pain medication. It’s best to consult with a medical professional to figure out the best plan for you and your body. And be sure that your physician knows all of the medications you’re taking, including those that are non-prescription.  

“Our goal is always to treatments that return our patients to a high quality of life without long-term repercussions from pain meds,” Dr. Mullins said.

If you have questions or concerns, please contact us at 775-786-6100 to discuss them so we can help you manage your pain in a safe and effective way.