What is the Opioid-Sparing Effect?

As the opioid crisis continues, overdose rates are at record highs. This fact has led medical professionals to search for alternative ways to treat pain, including the opioid-sparing effect.

Let’s take a look at what opioid-sparing is, how it works, and why doctors use it to improve pain management and reduce a patient’s risk for addiction.

The Opioid-Sparing Effect

Opioids are chemicals that interact with receptors on nerve cells and in the brain to reduce the intensity of feelings of pain. They can be natural, synthetic, or a mixture of the two.

Opioids include drugs obtained legally through a prescription like codeine and morphine, or illegal drugs such as heroin and fentanyl.

While prescription opioids can be safe when taken as directed by a doctor, there are many risks due to the euphoria and pain relief they provide. This increases addiction potential and causes them to often be misused. Opioid Use Disorder refers to a pattern of opioid use that results in addiction and dependence on the substance.

Issues with opioid abuse arise since prescription opioids used to treat moderate to severe pain are often prescribed after surgery or injury. Recently opioids have also been used to treat chronic pain – even though there may not be compelling evidence about their effectiveness in the long-term.

The opioid-sparing effect is a response to the opioid crisis we are facing. It aims to reduce the number of opioids prescribed and allow patients to explore pain relief options that are just as effective but do not carry the risk of dependence.

The goal is to address pain relief without, or with fewer opioids so that side effects and the possibility of addiction are minimized.

How does Opioid-Sparing Work?

The opioid-sparing effect works by providing alternative treatments and options for pain management that reduce the level of opioids required or eliminate them altogether.

For example, doctors can choose regional treatment during surgery that involves a needle containing a local anesthetic, rather than prescribing opioids. This option prevents the need for an opioid prescription, while still solving the need for pain relief.

Another option is prescribing medications without opioids, like NSAIDs and acetaminophen. NSAIDs – or nonsteroidal anti-inflammatory drugs – manage pain and decrease inflammation while reducing the side effects caused by opioids.

Although completely eliminating opioids from treatment may not always be an option, opioid-sparing challenges medical professionals to minimize usage as much as possible.

Why Medical Professionals Use It

We are in the midst of an opioid epidemic in which mortality rates are constantly on the rise. It is more important than ever to minimize the risk that a patient may become dependent on opioids.

Anyone exposed to prescription opioids can develop a dependence on them, and overcoming the addiction can be very difficult. In fact, up to 1 in every 4 patients prescribed long-term opioids struggles with addiction.

It is not uncommon that someone battling opioid addiction had their first exposure to it from a legal prescription. In addition to the issues with addiction, overuse of these substances can lead to overdose and death.

Doctors use opioids to treat the pain associated with surgery, all while outpatient surgeries are becoming more common. Outpatient procedures leave the burden of pain management on the patients or caregivers – which can lead to problems since the prescribing doctors are not supervising the use of the drugs.

Medical professionals who use opioid-sparing minimize the risk that a patient becomes addicted to the pain medication. Also, if the patient is recovering from opioid addiction, it reduces the risk of relapse.

Another issue doctors face is that a growing number of surgical patients develop a high tolerance for opioids. For instance, individuals with chronic pain may already have a very high tolerance for these substances, so they require higher dosages to be effective – further increasing the risk of dependency or overdose.

Opioid-sparing offers a better option for treatment and pain management since the risks are significantly reduced while still yielding the same results. In fact, studies have shown that opioid-sparing protocols reduce opioid consumption while also providing equivalent pain management.

Opioid-sparing can also minimize the side effects caused by opioids like drowsiness, nausea, and confusion. Using varying methods of pain relief can also be more effective since it can help address multiple pathways and lead to better results.

Conclusion

Above all else, the opioid-sparing effect is a way to directly combat the opioid crisis. It allows medical professionals to do their jobs and treat patients effectively without contributing to the risk that another individual will become addicted to opioids.

If you or someone you love is at risk for addiction, talk to your doctor to find out how he or she might make a plan for you that puts opioid-sparing in place as part of any upcoming treatment or surgical plans you have on the horizon.

About the Author

Paula Nicola, M.D.
Dr. Nicola is the Facility Director at Renu. She is a trained and board certified medical doctor with specialized training in addiction medicine.

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