opioid addiction In countries like the USA, this has already become quite a serious problem. Many people have found ways to acquire them on the black market, but it is also true that in many cases it all starts with the purchase. medical prescription. Therefore, the first step to try to put an end to this problem is to minimize the cases in which its use is justified. The truth is that, according to a group of Australian scientists, one of the first to be removed from the list is precisely one of the most common: use of opioids for back pain.
It is important to note that these scientists are talking about the use of opioids for back pain. spicy. This means that they did not focus on chronic or long-term pain, but on much shorter episodes of pain, both in the lower back and neck.
As the authors of the study explain in an article for TalkV Australia Opioids are prescribed for back pain in 40% of patients who see their primary care physician. Also 70% of those who go to the emergency room because of pain. This is a very high figure, but is it justified? According to a study published a few months ago in Lancetis not.
How do these drugs work?
In that nervous systemSignal transmission between neurons is facilitated by the release of substances known as neurotransmitters. These signals inform the brain about what is happening inside and outside the body, so when it receives them, it transforms them into a wide range of responses.
In the case of pain, it all starts with stimulating receptors called nociceptors. They can be activated in three ways: mechanical, chemical or thermal means. The first is the heat generated by impact, the second is an acid burn, and the third is a burn from placing your hand on a burning iron. It should be noted that painful stimuli are not always external. For example, the inflammatory response is painful because substances that bind to nociceptors are released.
Now, regardless of the type, chemical signals begin to travel through the nerve fibers until they reach the brain, where the painful reaction occurs. Along the way, like any signal of this type, it requires the release of neurotransmitters that promote the opening ion channels what causes potential difference which facilitates the propagation of the electrical signal. This is where opioids come into play.
There are other receptors called opioid receptors, which are usually open, allowing the release of neurotransmitters. However, when they are coupled with certain substances, also known as opioids, much of the electrical activity of the neuron in which they are found is suppressed. As a result, far fewer neurotransmitters are released and painful sign it remains halfway, without reaching an adequate brain.
These opioid substances can come from within the body itself. For example, famous endorphins, are opioids. But they can also be administered exogenously. There are natural opioids called opiates, including heroin and morphine. But there are also synthetic ones made in the laboratory. This group includes, for example, fentanyl and oxycodoneamong the others.
Beware of Opioids for Back Pain
Authors of the study LancetKnowing how addictive opioids can be, I wanted to see if they were really necessary for treatment acute back pain.
To do this they took part 347 people Diagnosed with acute pain in the lower back or neck. They were randomly divided into two groups. Patients of the first group received a controlled dose oxycodone and naloxone. This latter substance reduces some side effects, such as constipation, but does not affect oxycodone’s ability to relieve pain.
Participants of the second group took placebo. That is, tablets with absolutely the same appearance, but without the active substance.
Treatment continued for maximum six weeksin which health care providers also focused on teaching patients postures and activities to minimize pain. without pharmacological interventionj. After this time, participants were asked how they felt. It should be noted that they did not know whether they were taking opioids for back pain or a placebo, so they could not be asked.
It is therefore interesting that pain did not decrease more in the drug group. compared to placebo. There were also no improvements in other factors such as physical functioning, quality of life, recovery time, or absenteeism from work. And, of course, there were more side effects in the group taking opioids for back pain.
Among these side effects, one that stood out was that the pain, instead of decreasing, in some cases it got worse over time. And also that there were patients who began to show signs of addiction.
Disclosure is important
These scientists both conclude Lancet how in Talk What are the benefits of opioids for back pain? they don’t compensate for the risks. In fact, when it comes to acute pain, there doesn’t even seem to be any benefit.
So they bet on educate and support patients. In another previous study, they found that something like giving patients lifestyle advice, providing them with heating pads and anti-inflammatory analgesics, or outpatient monitoring to avoid queues could be much more effective against acute pain.
It is true that not everything is solved by disclosure and living a better life. However, in cases where the pain is very severe, anti-inflammatory drugs should be sufficient. This is a good way to reduce your consumption of medications that have proven to be very dangerous if their use is not optimized.
Just as doses of drugs such as antibiotics, which are inherently necessary but dangerous if abused, have been adjusted over time, the same should be done with opioids. It’s not about demonizing them, it’s about knowing when it is actually justified to use them.
Source: Hiper Textual
