Opioid Addiction is Chronic Brain Disease

"For far too long people have thought about substance abuse disorders as a disease of choice, a character flaw or a moral failing. We underestimated how exposure to addictive substances can lead to full blown addiction.

Opioids are a good example.

Now we understand that these disorders actually change the circuitry in your brain. They affect your ability to make decisions, and change your reward system and your stress response. That tells us that addiction is a chronic disease of the brain, and we need to treat it with the same urgency and compassion that we do with any other illness." - U.S. Surgeon General Vivek Murthy

Opioids have their place in pain management. They also should be respected as the powerful mind molders they are. Primary care physicians (PCPs) are increasingly the prescribers of opioids. A higher percentage of patients that see PCPs are addicted to opioids as compared to the patients of specialists. The goal of Integrated Relief is to educate about the options that are available for primary care and specialty management of pain.

Many times people receive opioids as pain management due to lack of access to specialists or because they cannot afford to pursue other avenues. Taking a pill may mean that one doesn't have to take off work to go to weekly physical therapy sessions. Patients can have stress from pain that isn't helped with non-steroidal anti-inflammatories. Opioids can help relieve that stress while treating the pain, but so can some antidepressants. Patients often aren't offered the latter option because they are not informed of their multiple actions. Also, because antidepressants generally don't cause drug seeking behavior, patients don't request them for pain management and never get to try out a non-opioid option.

Primary care physicians are often overburdened and lack the time to sort through a complicated case to find the root of the pain. Opioids are an economical solution to solving patients' needs. Doctors often can simply not afford the time it takes to sort out imaging, balancing non-opioid prescriptions, rehabilitation, cognitive behavioral therapy, and other factors. Things get even more complex when one considers the modalities non-allopathic physicians bring together to treat pain.

Please enjoy some information about the role of the primary care physicians and opioid prescriptions:

Decision support for chronic pain care: how do primary care physicians decide when to prescribe opioids? a qualitative study

Survey of select practice behaviors by primary care physicians on the use of opioids for chronic pain

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Surgeon General Murthy Wants America To Face Up To Addiction