Toronto Opioid management and cessation.
Opioids are among one of the world’s oldest drugs and this class encompasses natural derivatives from opium such as morphine, as well as semi-synthetic and synthetic pharmaceutical compounds including hydrocodone, oxycodone and fentanyl.
There are even opioids that are peptides and endogenous to our bodies, such as the endorphins.
For centuries the class of opioid drugs have been regarded as one of the most effective medications for the treatment of acute severe pain, and chronic pain. The use of opioids in Toronto for management of pain related to advanced medical illness continues to be standard care.
Use of opioids in pain management
Opioids have been indicated for the therapeutic relief of mild to severe pain. However, due to their properties, they are typically reserved for patients who experience more moderate to severe pain. For individuals that are seeking treatment for mild pain, a weak opioid called codeine is often available in low doses and in combination with one or more other drugs without a prescription.
For the treatment of acute moderate to severe pain, opioids have been proven to be effective in providing immediate relief. Therefore, opioids are frequently a treatment of choice due to their efficacy, rapid onset and reduced risk of dependence. Opioids are also very important in cases where patients require palliative care to help cope with the severe, chronic pain associated with terminal and degenerative conditions such as cancer and rheumatoid arthritis. In fact, opioids have been an effective therapeutic strategy for chronic cancer pains.
Aside from their uses in cancer-related pain management, opioids are also effective for treating chronic non-cancer pain. However, it’s important to note that the risks of opioids become greater than benefits when they are used for non-cancer-related conditions such as headaches, back pain and fibromyalgia. If the opioids are used cautiously and temporarily for non-cancer pain, the opportunity for risks and dependency can be decreased. When we prescribed opioids to our patients, we monitor and reassess the benefits and considerations for the treatment at least every three months for attentive management and adjustment.
Due to its high health risks and addiction rates, Toronto opioid treatment for chronic non-cancer related pain management are offered after other therapeutic options. These less risky pain relievers include paracetamol, acetaminophen or NSAIDs such as ibuprofen or naproxen. With certain conditions like fibromyalgia or migraine headaches, we can actually achieve better clinical outcomes without the use of opioids. In fact, opioids are contraindicated as a first-line treatment for chronic headaches because they impair alertness, increase episodic headaches and can increase sensitivity to the headache pain. We only prescribe opioids for treating headaches when all other treatments have failed or are unavailable, however, the patient must be carefully monitored to prevent the aforementioned side effects.
Toronto Opioid Addiction
As chronic pain becomes a growing healthcare concern around the world, the use of opioids for pain management has also increased. Once prescribed freely, with less health consideration, this practice has led to a new problem with addiction and misuse of opioids. Therefore, proper strategies for managing the use of opioids are necessary to ensure patients can benefit from medication without being unnecessarily at risk for dependency. Again, the determining factors and preconditioning of each client is viewed individually so that the whole health picture can be assessed for optimal planning. At our clinic, we offer our patients treatment options with less problematic pain relievers as a front line approach, as some conditions involving nerve pain; migraines etc. do not respond well enough to warrant the use of opioids. Some safe alternatives that we prescribe are paracetamol and NSAIDs, like ibuprofen and naproxen. These alternative drugs may be used in combination with opioids to increase the effects while minimizing the negative impacts of opioids.
The mechanism of action for opioids in pain management
Opioids are a class of drugs that act on opioid receptors to produce analgesic effects.
Like anesthesia, they are primarily and frequently used for relieving pain in specialized clinics. In addition to use for pain relief, opioids can also suppress diarrhea, act as replacement therapy for opioid use disorder, reverse opioid overdose, suppress coughs and suppress opioid-induced constipation.
Opioids chemical compounds bind to opioid receptors that are primarily located in the central and peripheral nervous system and in the gastrointestinal tract. This is the reason that so many gastrointestinal issues are treated with these drugs. These receptors are responsible for mediating the psychoactive and the somatic effects of opioids. Gut health, then, becomes an important factor in the metabolism and processing of opioids in a person’s system.
The associated side effects of opioids
Although opioids offer significant benefits for patients with acute or chronic pain, there are potential side effects associated with use of these medications. Common side effects include itchiness, sedation, nausea, respiratory depression, euphoria and constipation. Long-term use of opioids can lead to increased tolerance and dependence, which is when a patient’s body becomes accustomed to the drugs and requires increasing doses to derive any benefits. Unfortunately, as doses increase to bring relief, so do the negative effects and stress on the body. The development of tolerance and dependence will also lead to an increased risk for withdrawal symptoms upon discontinuation.
Unlike many other alternative drugs for pain management, opioids do not cause any specific organ toxicity and are not associated with upper gastrointestinal bleeding.
Importance of opioid management
Despite the efficacy of opioids for pain management, this category of drug continues to draw negative and even tragic attention because of its reputation for addiction and fatal overdose. Therefore, most opioids are considered to be controlled substances in Toronto and require a prescription with careful oversight from a medical doctor. With the appropriate management of opioids with our physician and medical staff, we minimize our patients’ risk of developing addiction to any medication and ensure they are used as intended.
Proper management of opioids is important as not all patients respond with experiencing the same therapeutic effects. Patients must have medication prescribed in a customised manner and use it as directed to have the best benefit. There are several factors that contribute to a patient’s treatment with an opioid, including:
- Pain severity
- Pain treatment history
- Co-existing conditions
- Current medications
- History of substance abuse
Your doctor must be evaluating all these influencing factors in order to safely and effectively prescribe opioid medication in Toronto. A significant value is placed on pain severity when it comes to opioid management for patients. We prescribe particular opioid medications depending on the severity of pain reported. For example, mild to moderate pain are typically treated with opioid combination products like codeine/acetaminophen while severe pain may necessitate a stronger opioid to resolve the issue.
Tips on using opioids safely for pain management
The use of opioids, for even short periods of time, has the potential to create dependence and overdose.
Here are some steps to take for safe medication administration and maximized pain relief:
- Openly communicate with the medical staff and physician regarding any history of substance abuse
- Follow all the directions provided by the physician to avoid incorrect dosages of opioids, which can lead to side effects and overdose
- Learn which substances should be avoided while taking an opioid to avoid adverse reactions
- Store the opioid medications in a safe spot, in the prescriptive, labelled container, inaccessible to others, especially children
Tolerance and withdrawal from opioid medications
Tolerance is a term used describe a state that a patient’s body may develop as they take opioids for an extended period of time. In the case of increased tolerance, patients find that they need increasingly higher doses of medications in order to achieve the same level of therapeutic pain relief. It is very important that the physician is notified if this occurs.
Withdrawal can occur if patients suddenly discontinue their opioid medication. Therefore, we have discussions and strategies for safe opioid cessation, especially since patients with chronic pain conditions on prescribed opioids differ from individuals with other types of addictions. Some patients need to slowly taper their use of opioids in order to successfully stop their use of opioids.
At our pain management clinic, Dr. Dov Weiss and our team are dedicated to helping people feel empowered and in control of their conditions. If opioids are a part of a personalized treatment plan, we will work diligently to ensure that the journey to pain relief is a safe one through effective management and cessation of the medication.
Our team at Painless Medicine and Therapeutics focuses on improving our patient’s pain conditions.
Our goal and philosophy is to make the patient’s therapeutic experience as painless as possible by finding a therapeutic plan that best treats their symptoms and lifestyle. We truly believe in collaboration and working closely with patients so that they have control over their medication, and so that the treatment aligns with our clinic’s values.
In cases where chronic pain cannot be cured, but instead must be effectively managed, our team’s purpose is to limit the complications and to minimize the severity of the symptoms experienced by the patient. We wish to optimize our patients’ control over their pain so they feel enabled to be the best possible version of themselves and enjoy life again.
If you are suffering from a chronic pain condition, we highly suggest that you visit our clinic in Toronto to see what we can do for you.