A new white paper suggests a common medical practice to treat pain is doing more harm than good.
Over the last decade, an increasing number of studies have shown the dangers of over-prescribing opioid painkillers.
Despite that, the U.S. consumes 80% of the world’s opioids with only 4.6% of the population.
The new paper from the National Safety Council, The Psychological and Physical Side Effects of Pain Medications, summarizes the studies and concludes that opioids “should only be used with great caution when all other options have failed.”
Of particular interest to employers who are dealing with injured workers:
- Use of opioids following an injury delays recovery and increases the risk of re-injury and permanent disability.
- In larger doses, opioids are “markedly impairing,” leading to drowsiness and lethargy. The effects under smaller doses are less well known, but the NSC says “it is reasonable to assume that those with pain who are on opioids likely have some cognitive impairment.”
- Opioids can cause a phenomenon known as hyperalgesia: an increase of sensitivity to pain.
These and other effects are estimated to cost $25 billion in workplace-related costs per year. Among the costs: increases in workers’ compensation insurance premiums and reduced productivity.
So what are the alternatives? NSAIDs (nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen) are known to cause gastrointestinal, renal, cardiac and bone problems. Acetaminophen can cause liver damage when used in higher doses for prolonged periods of time.
All pain medications have potential side effects. The NSC paper suggests NSAIDs and acetaminophen are preferable to opioids. But there’s another alternative.
The NSC also recommends:
“Insurance companies should develop mechanisms to facilitate non-drug treatment of pain including appropriate physical therapy and counseling.”
Physical therapy we know about. But counseling?
A new book, Touch: The Science of Hand, Heart, and Mind, by Johns Hopkins University neuroscience professor David Linden, says we can train our brains to pay less attention to pain.
Linden says the brain uses two different systems to process pain:
- One system focuses on the pain’s location, intensity and characteristics
- The other deals with the emotional aspect of pain – “the part that makes us go, ‘Ow! This is terrible.'”
Positive emotions can reduce pain, according to Linden. But negative ones can increase it.
Research from Brown University suggests some people can teach their brains how to filter out chronic pain, perhaps through meditation. Another study backs up that hypothesis.
What do you think about all this? Would you be in favor of workers’ comp insurance paying for psychological treatment, including meditation training, to help someone injured on the job deal with chronic pain? Let us know in the comments.