Avoiding Opioids: There are Alternatives

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BOWLING GREEN, Ky. (WBKO) -- 3:00 a.m. Sunday, July 30, Nashville Mayor Megan Barry is awakened by a Metro Police Sergeant at her front door. He tells her, her only child has died from it. In 2016, more than 1400 Kentuckians died from it. And just last week, President Trump called it "a national emergency."

It is opioid addiction, and it kills 142 people a day. But there is hope. In Michigan, overdose-reversing drugs have been known to save lives.And now hospitals across the country, including The Medical Center in Bowling Green, are coming up with alternative pain relief treatments.

To first understand opioids, we need to know exactly what they are.

"An opioid is a synthetic medication which is basically used to mimic the action of morphine which is a pain reliever." Dr. Paul Maglinger, a pain management specialist at the Medical Center, says the most widely used opioids are Hydrocodone, Oxycodone, and Fentanyl.

"Fentanyl is really a hot-button medication right now," says Dr. Maglinger, "because that is one that is now being synthesized illicitly. And that medication can be especially dangerous because it has a propensity to slow down and stop breathing. And we've seen a big spike in the last couple of years of opiate-related deaths related to the use of Fentanyl or medications like Fentanyl that are veterinary-grade."

Dr. Maglinger says opioids are often used to alleviate acute or chronic pain long-term, but there's now a rush to eliminate their use, because they are riddled with side effects. "Out of all the patients that are started on an opiate for a period longer than a week, 8% of them can start showing some signs of addiction behavior. That can include hoarding pills, taking pills inappropriately, sharing pills, buying pills off the street."

Dr. Maglinger says the Kentucky medical community is trying to curb the use of opiates, by using other methods of pain relief. One of them is a peripheral nerve block to numb the area of the operation, eliminating the use of high-dose opiates for a longer period of time, thereby reducing the experience of side effects, and lowering the risk of addiction.

Courtney Clark was in her late 20's when she went to the Medical Center for a bunion on her left foot. It may sound funny, but the pain is excruciating, and she grew up it. Courtney had the surgery, but the post-surgical pain was unbearable, so she was given an opioid pain medication called Lorcet. "And for me, what was prescribed didn't help. I would wake up. It was throbbing pain. And so that was not good. And the side effects for me, I was throwing up, nauseous, just not getting better."
Gene: "So you had terrible side effects but you never became addicted?"
Courtney: "Correct. Correct. I didn't take enough to get me to an addiction point or anything like that. It was just, I wasn't getting better."

Courtney missed two weeks of work, and had to take it easy for 6 months. She waited 10 more years before she had the bunion on her right foot removed.

Gene: "You waited that long because...
Courtney: "It was painful, ha, ha, ha, ha, ha. It was very painful and I remembered it, y'know I was like I really don't want to do this again. But you get to the point where the pain outweighs the side effects of the surgery. And then, realizing there was different methods, different alternate ways to help with the surgery and help recovery, and that helped make the decision a little bit easier."

But instead of using an opioid, this time the doctors inserted a pain block in Courtney's knee, which she says provided easier and more effective pain relief than in her first operation. And her recovery time was cut in half! "And I really think I only took like just a handful of pain medications. So it was night and day different. I went back to work in a week."
at does the future hold?

Dr. Maglinger says, "The Holy Grail is finding a medicine which doesn't have these terrible side effects and addictive qualities, but still gives good pain relief. We do have some medicines I think that are being developed now, that have the potential to achieve that Holy Grail."

A study in 2013 revealed, that 80% of heroin users reported using prescription opioids before heroin.​​ To help fight the opioid epidemic here, the Kentucky legislature passed a law in June, placing a three-day limit on opioid prescriptions for acute pain. It's the toughest law in the nation.



 
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