Middleway Medicine Blog

The Truth About Opioids

By Clark Zimmerman, LAc

My grandmother was never a fan of air conditioning.  I remember visiting her farm in the heat of summer and spending a lot of my time swimming in the pond, rather than sweating buckets inside the house.  Though my mom insisted it was because she had lived through the depression and didn’t want to spend the money, grandma insisted that air conditioning made you more sensitive to the heat.  “If you just learn to tolerate the heat, and drink iced drinks or go swimming” she reasoned, “than there is no real need for air conditioning.”  I thought of my grandma’s wisdom while reading a recent study by Peter M. Grace and Linda R. Watkins of the University of Colorado.  The study found that opiate pain medications, such as morphine, oxycodone, and Vicodin can have the “devastating consequences of making pain worse and longer lasting”.  Like my grandmother’s opinion of air conditioning, it seems that rather than effectively treating pain, opioids often can help us feel more comfortable in the short term, but can cause lasting sensitivity to pain.

As opiate addiction continues to grow in the U.S., and deaths from overdose by opioids become more common, people are beginning to ask if the benefits of opioids are worth the risks that are involved. This recent study is the latest bit of evidence that something needs to change.  The healthcare community is truly beginning to evaluate when to use opiate medications and when other treatment options would be more appropriate.  This latest research suggests that the conditions that can benefit from opiate use are not as numerous as we once believed.  In my practice, I have seen many people who began using opiate pain killers to treat a traumatic injury or a nagging condition with the belief that things would quickly improve and the pain medication would no longer be necessary.  When the pain lingers because their injury is not properly addressed or because their lifestyle that contributes to their pain is not altered, they become dependent on the medication.  This results in the unfortunate situation of needing more medication to achieve the same amount of pain relief, which can easily lead to opiate addiction.  Another thing worth mentioning is that the body experiences pain to help get your attention.  If, for instance, you tear a muscle lifting a heavy box, you feel pain so that we know to quit using that muscle until it heals.  If you cover up the pain with medication, sometimes it allows you to keep doing physical work that your body cannot perform.  This can often result in more damage to your body.

I believe that opiate pain medications are often prescribed when other treatments  such as ice/heat, rest, massage, acupuncture, chiropractic/osteopathic manipulations, physical therapy, or herbal preparations would be a better choice.  These treatments attempt to address the underlying problem that is causing the pain, rather than cover up the pain in general.  It seems that we are coming to a point as a society where this issue cannot be ignored any longer.  Opiate pain treatments do have a place, but only in very specific situations of severe and otherwise untreatable pain, and only under the close supervision of a skilled and attentive medical practitioner.  Not only is widespread opiate  medication creating problems in our communities, it now appears that it is largely ineffective.

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The Truth About Opioids

By Clark Zimmerman, LAc.

My grandmother was never a fan of air conditioning.  I remember visiting her farm in the heat of summer and spending a lot of my time swimming in the pond, rather than sweating buckets inside the house.  Though my mom insisted it was because she had lived through the depression and didn’t want to spend the money, grandma insisted that air conditioning made you more sensitive to the heat.  “If you just learn to tolerate the heat, and drink iced drinks or go swimming” she reasoned, “than there is no real need for air conditioning.”  I thought of my grandma’s wisdom while reading a recent study by Peter M. Grace and Linda R. Watkins of the University of Colorado.  The study found that opiate pain medications, such as morphine, oxycodone, and Vicodin can have the “devastating consequences of making pain worse and longer lasting”.  Like my grandmother’s opinion of air conditioning, it seems that rather than effectively treating pain, opioids often can help us feel more comfortable in the short term, but can cause lasting sensitivity to pain.

As opiate addiction continues to grow in the U.S., and deaths from overdose by opioids become more common, people are beginning to ask if the benefits of opioids are worth the risks that are involved. This recent study is the latest bit of evidence that something needs to change.  The healthcare community is truly beginning to evaluate when to use opiate medications and when other treatment options would be more appropriate.  This latest research suggests that the conditions that can benefit from opiate use are not as numerous as we once believed.  In my practice, I have seen many people who began using opiate pain killers to treat a traumatic injury or a nagging condition with the belief that things would quickly improve and the pain medication would no longer be necessary.  When the pain lingers because their injury is not properly addressed or because their lifestyle that contributes to their pain is not altered, they become dependent on the medication.  This results in the unfortunate situation of needing more medication to achieve the same amount of pain relief, which can easily lead to opiate addiction.  Another thing worth mentioning is that the body experiences pain to help get your attention.  If, for instance, you tear a muscle lifting a heavy box, you feel pain so that we know to quit using that muscle until it heals.  If you cover up the pain with medication, sometimes it allows you to keep doing physical work that your body cannot perform.  This can often result in more damage to your body.

I believe that opiate pain medications are often prescribed when other treatments  such as ice/heat, rest, massage, acupuncture, chiropractic/osteopathic manipulations, physical therapy, or herbal preparations would be a better choice.  These treatments attempt to address the underlying problem that is causing the pain, rather than cover up the pain in general.  It seems that we are coming to a point as a society where this issue cannot be ignored any longer.  Opiate pain treatments do have a place, but only in very specific situations of severe and otherwise untreatable pain, and only under the close supervision of a skilled and attentive medical practitioner.  Not only is widespread opiate  medication creating problems in our communities, it now appears that it is largely ineffective.

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Prescription Pain Killers: A treatment of last resort

By Clark Zimmerman, LAc. 

Pain is part of being human.  We all have to deal with pain of varying degrees throughout our lives.  When pain is minor most people can continue on with their regular activities without much trouble.  When pain becomes more severe most people reach for an over-the-counter medication such as ibuprofen or acetaminophen.  These medications can offer some relief, and allow people to continue on with their normal activities.  When these medications are not successful in alleviating pain most people go to their doctor and get a prescription for opiate pain medications, such as Vicodin or oxycontin.  These medications can be helpful in some situations by providing relief while a person heals enough that their pain diminishes to a manageable level.  Unfortunately they do not address the underlying issue which causes the pain, such as muscle tension or strains, inflammation or a misalignment of bones. Opiate pain relievers also can cause some significant side effects, including constipation, nausea/vomiting and drowsiness.  They can also mask the pain to the degree that someone continues to do certain activities that may make an underlying injury or imbalance worse.   One of the biggest drawbacks of opiate use is their high risk of addiction.  According to a recent NPR story, Oregon has the unfortunate distinction of being the national leader in non medical use of opioids:

In 2012, about 1 in 4 Oregonians received an opioid prescription — more than 900,000 people.  The state also currently leads the nation in non-medical use of opioids, and about a third of the hospitalizations related to drug abuse in Oregon are because of opioids. 

Another problem with opiates is that over time patients develop a tolerance for the drugs that create a need for a larger dose to achieve the same pain relief.  This leads to an increased likelihood of developing an addiction that can linger even after the initial pain has been alleviated.  Prescription pain killers can also make people more sensitized to pain causing people to experience an increase in pain levels over time.   

While opiates do have their place in treatment, the high risks involved in their usage should make them a treatment of last resort.  Instead people suffering from pain should try some of the simpler options first such as ice, rest, stretching, proper posture and exercise.  Massage, acupuncture, physical therapy and chiropractic can also be used to help treat the underlying problem and help to heal the cause of the pain in a more holistic and permanent way.  If these less risky and more deliberate methods do not succeed to lower pain levels, then pain killers can be a possible addition to the treatment plan for short term use. 

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Clark Zimmerman, LAc, MAcOM
Ann Zimmerman, LAc, MAcOM
Ryan Baker, MAcOM, LAc, RPh

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