While it’s common to give patients prescription drugs after surgery, a recent study questions the prevailing practice. The study in mice indicated that the use of opioids after surgery could be counterproductive. The finding has raised concern among various stakeholders, including doctors, experts, scientists, etc., who fear its consequences on the pain management of patients.

The study highlights some of the darker, lesser-known aspects of opioids that are likely to worsen the ongoing battle against the opioid crisis. Since the human physiology of both mammals (mice and humans) is quite similar, researchers are concerned. Linda Watkins and Peter Grace of the University of Colorado Boulder performed exploratory abdominal surgery on male rats.

Also known as laparotomy, it is a fairly common surgery in the United States. During the course of the study, around three experiments were conducted to understand the long-term impact of morphine. First, half of the rats were given a moderate dose of morphine for seven days after surgery and the other half were given a saline solution. Second, the mice were given morphine for eight days, then tapered off on the tenth day. Finally, the mice were administered morphine for 10 days, after which it was abruptly discontinued.

Some of the revealing findings were as follows:

  • Rats given morphine experienced pain for more than three weeks.
  • The duration of pain depends on the duration of morphine intake; prolonged use of morphine makes the pain last longer.
  • The gradual reduction did not affect the pain; this was not the result of withdrawal, but other factors at work.

The researchers identified that the extent of postoperative pain was primarily due to increased expression of inflammatory genes, including those encoding Toll-like receptor 4 (TLR4), NOD-like receptor protein 3 (NLRP3), nuclear factor kappa B (NF -κB), caspase-1 (CASP1), interleukin-1β ((IL-1) and tumor necrosis factor.

Non-opioid alternatives to combat pain

The opioid crisis is undoubtedly one of the worst epidemics to hit the United States in recent times. While opioids were considered the best cure for chronic pain a couple of years ago, they are now under intense scrutiny. Stanford pain specialist Sean Mackey agrees that opioids should never be the first-line treatment because of the risks they carry. Instead, non-opioid alternatives should be tried first, he suggested.

According to Mackey, there are currently more than 200 non-opioid pain medications. Non-opioid medications, such as acetaminophen used for osteoarthritis, low back pain, and migraine, do not cause fatal overdoses associated with opioids. Similarly, topical agents such as tricyclic antidepressants (TCAs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are used to treat localized musculoskeletal pain, osteoarthritis, etc.

Non-pharmacological interventions, such as exercise therapy and cognitive behavioral therapy (CBT), play a crucial role in pain management. While exercise therapy improves general well-being and promotes happiness in patients, CBT reduces pain and improves functioning in daily life. In addition to educating the patient on relaxation techniques and sequential breathing, CBT guides the patient through the development of coping strategies necessary to mitigate pain.

Timely intervention essential for recovery

Being highly addictive in nature, prescription drugs, specifically opioid pain relievers such as Vicodin and hydrocodone, increase the risk of developing addiction. Timely intervention is essential to contain the spread of addiction. If left untreated, the consequences of prescription drug abuse it could be deadly.

More than anything, it is necessary to recognize that each person living with pain has their own unique history and needs. Not everyone living with pain will respond in the same way to treatment. So while exercise therapy and medications might work for one, they might not necessarily work for others. Therefore, one must be careful and cautious while taking these drugs.