America’s Worst Drug Epidemic in History: The Opioid Crisis
We are in the middle of one of the deadliest epidemics in American history. Deaths from opioid overdose have quadrupled since 1999, with six out of ten overdose deaths in the U.S. involving an opioid drug. More than 1,000 patients are treated in emergency rooms daily for misuse of prescription opioids, and more than 500,000 people died from drug overdoses between 2000 and 2015.
Death rates from opioids now rival those of AIDS during the 1990s, far more than any other drug, yet opioid prescriptions have risen so sharply that in 2012, enough opioids were prescribed to supply every U.S. adult with his or her own bottle, according to the CDC. It has gotten so out of control that twelve states now have more opioid prescriptions than people. So with the opioid crisis finally coming to a head, medical professionals and pain management specialists are increasingly looking for alternative ways to control chronic pain.
Non-Opioid Alternative Treatment for Chronic Pain
The way we reduce opioid prescriptions is by finding alternative options for pain management that don’t have the dangerous side effects of opioids. Individuals who consume opiates over an extended period of time can develop a tolerance, requiring them to take more of these painkillers to elicit the same effect. This process can lead to addiction and increase the risk of overdose and death. Dr. LaPietra from St. Joseph’s Emergency Department in New Jersey helped launch the ALTOSM (ALTernatives to Opioids) Program in January 2016, which found ultrasound-guided nerve blocks as a safe alternative to opioids. “Hip fracture pain is exquisite,” says Dr. LaPietra, “(Patients) are in a lot of discomfort. They cannot move; they cannot breathe well. And within 5-10 minutes of the (ultrasound-guided) nerve block, she had complete pain relief.”
Non-Opioid Alternative Benefits of Ultrasound-Guided Nerve Blocks
Regional nerve blocks provide a better alternative for pain relief than opioids because they work locally. An anesthesia provider injects a local anesthetic and/or steroid around a specific nerve, group of nerves, or within a fascial place to reduce pain and inflammation. “What we are looking for is multimodal anesthesia,” said Yili Huang, DO, director of Northwell Health’s Pain Management Center. The modality is appropriate for any condition that involves nerve pain such as arthritis, sciatica, and chronic knee or back pain. “We want to balance our patients’ need for pain relief while limiting opioid use,” says Dr. Huang. “Nerve blocks give us a powerful non-opioid alternative.”
Additional Non-Opioid Benefits of Regional Nerve Blocks
Injuries that cause chronic nerve pain often require physical therapy, but many patients have too much pain to do P.T. An ultrasound-guided regional nerve block provides enough relief to allow patients to pursue physical therapy and regain strength. Not only that, but patients cannot develop a tolerance to nerve blocks, which provides a safe pain relief alternative for patients who have struggled with substance abuse and need to avoid taking addictive painkillers. All of these benefits are why more and more physicians are turning to ultrasound-guided nerve blocks instead of opioids. “I want to get the most bang for my buck,” said Dr. Huang. “The most pain relief for my patients from the least amount of medication. My job is to give them the relief they need to recover.”