Pain is a chronic, debilitating health condition that can significantly impair people’s daily lives. In America alone, over 51 million people were struggling with chronic pain as of 2021, which is almost 21% of the U.S. population. What’s more, more than 17 million people reported experiencing acute pain, which restricted their mobility and routine activities. With such alarming figures of people who deal with pain on a daily basis, it is not surprising that the market for painkillers is thriving.
However, when it comes to pain management medications, the legal landscape is not that simple. The reason is that many high-impact analgesics are opioids – addictive drugs with adverse, far-reaching repercussions. The use of narcotic pain relief medicines was widespread in the 20th century, with such drugs intended to block post-surgical pain or other acute painful conditions. The practice was discontinued in the 2000s after a series of audacious legal cases involving painkiller use and abuse, turning into lifelong addictions for patients (e.g., the OxyContin painkiller sold by Purdue Pharma).
Therefore, the present-day laws governing painkiller prescriptions are sophisticated and complex, putting physicians in the disadvantage of risking a medical malpractice lawsuit in case of improper painkiller prescriptions. This article dives deep into the regulations governing painkillers and examines legal and illegal remedies for pain.
Legal Background: Painkiller Abuse Cases
Medication prescriptions are overseen by the Drug Enforcement Agency (DEA), a body that implements the Controlled Substances Act (CSA) guidelines. The main precedents on which the present-day case decisions rely are the United States v Moore (1975) and the United States v Hurwitz (2004) cases, both of which ended with physicians’ pardons. These cases set the good-faith standard that determines the medical practice’s propriety without vicious intentions. Therefore, the rule of thumb is to consider the physician’s history of work with specific opioids and their subjective perception of sufficient dosing that can help patients address pain adequately.
Main Subject of Controversy: Opioids
So, let’s take a closer look at the main subject of legal controversy in pain treatment – opioids. The CSA tightly regulates this class of drugs, to which heroin, synthetic drug fentanyl, and prescription drugs like OxyContin, Vicodin, codeine, and morphine belong.
The problem with opioids is that they are highly addictive, no matter the objective reason for prescribing them in pain treatment. According to the NIH statistics, only in 2021, over 80,000 patients died after accidental overdoing of opioids. Therefore, the use of this painkiller class, even under prescription, comes with multiple risks, such as addiction, opioid abuse, and death.
How do opioids act on the human body, and why are they so dangerous? Here’s the main mechanism of their action:
- Opioid agents bind to mu-opioid receptors in the human brain, which are responsible for painful sensations and bodily discomfort. Thus, they can produce a potent painkilling effect by blocking those receptors.
- Opioids can also act as cough suppressants due to their binding mechanism in the nerve cells.
- The byproduct of opioid action that has made these drugs so popular among addicts is intense euphoria and a cerebral high. That’s why most painkillers’ effects are associated with the effect of an illegal drug, heroin.
- If a user overdoses on opioids, they may suffer an acute suppression of the respiratory system that often results in coma and death. Both dependence and withdrawal from opioids are associated with nausea, mental disorientation, constipation, and drowsiness.
The greatest source of danger in the USA currently emanates from fentanyl – a synthetic opioid that acts 50-100 times more intensely on the user than heroin. It was initially marketed as a painkiller for people with terminal cancer at the end stage but was quickly spread as a super-potent illegal drug. The lethal dose of fentanyl is only 2 milligrams, which increases the rates of drug abuse-associated lethality among people buying drugs on the streets.
Alternative Remedies for Pain
Opioids offer fast relief for pain, but the cost is too high for most patients. In many cases, they end up with a debilitating and costly lifetime addiction, which impairs their social, cognitive, and occupational activities. Besides, physicians are increasingly reluctant to prescribe painkillers of the opioid class because of the fuzzy legal landscape and looming risk of criminal prosecution in case of improper dosing or suspected abuse.
Thus, the medical and patient community must seek alternative treatments for chronic pain that can work not as aggressively as opioids and, at the same time, offer substantial relief and life comfort. Here are some alternatives that patients can explore with their physicians on the way to managing pain.
- Acupuncture. This practice can help people with 30+ health issues, including pain relief, as recognized by the WHO. It is an ancient tradition that Chinese doctors were using in the 16th century to balance body energies. Thus, people can enjoy the benefits of ancient Chinese wisdom today, correcting in-depth imbalances and health issues causing pain.
- Yoga. Yoga practices have many health benefits, from flexibility and body strength development to meditation and mindful breathing techniques. Thus, regular yoga exercise can make you more mindful, resilient to pain, and in better control of your body.
- Herbal remedies. Growing painkillers in your own garden is a common practice among health-conscious people. Herbs such as white willow bark, Boswellia, bromelain, ginger, and turmeric all possess painkilling properties and can be used in herbal mixes during the day. You can also enjoy CBD-infused products for pain, which are herb-enriched – for example, the CBD roll on for pain relief is a great way to get your sore muscles and joints back to normal.
- Massage. Massage is highly helpful for those who suffer from chronic back and neck problems, as it reduces muscle stress and restores blood flow in painful areas. This way, regular massage sessions can help people avoid pain in these areas and deal without painkillers after long, stressful days of working in front of a computer.
- Aromatherapy. The power of aromas is well known, with many aromatic mixes used since times immemorial to treat various conditions and help people restore emotional balance and well-being. You may try lavender, bergamot, peppermint, chamomile, and ginger, among others, to treat pain and attain greater comfort.
Pain Is Not a Sentence
As you can see, the legal landscape is pretty restrictive for strong painkillers today, and many physicians get cautious about opioid prescriptions to avoid legal trouble. However, these legal bottlenecks shouldn’t leave you one on one with chronic pain; try legal drugs first and consider a variety of alternative remedies with proven painkilling effects. Though the outcome won’t be as immediate as with a toxic, addictive pill, the alternatives can bring you back on track and help you hinder acute pain episodes to restore quality of life.
The author of this article is Denys Svirepchuk, an expert in CBD applications for various medical conditions, including chronic and acute pain. Denys writes blogs for the AskGrowers resource to educate the public about dosing, safety precautions, and product choices for proper pain management with cannabidiol.