Alternatives to Opioids: What Works and What Doesn’t

Due to the opioid epidemic, more people are turning to opioid alternatives to alleviate their pain. But are they effective? Do the alternatives to opioids present dangers of their own?

Some people turn to herbs like kratom or other natural remedies like CBD (cannabidiol) oil to manage their pain instead of using opioids. There are also medical treatments people can discuss with their doctors, such as certain types of injections, implantable pain pumps, or spinal cord stimulation.
For some people, a combination of alternative treatments is the most beneficial.

Why Do People Use Opioids?

Some people start using opioids to relieve pain related to various chronic and acute conditions. With regular use, tolerance forms, prompting users to take higher doses than prescribed to experience the same level of relief.

Other people abuse opioids to experience the euphoria and relaxation that these drugs can provide.

In the U.S., more than 2 million people abuse opioids.

No matter why someone started using opioids, addiction can take hold quickly once abuse begins.

Why People Seek Out Alternatives

Opioids can cause a variety of undesirable effects that can adversely impact the quality of life. Some of the short-term effects that can occur are:

  • Nausea
  • Slowed breathing
  • Confusion
  • Euphoria
  • Drowsiness
  • Constipation

As tolerance forms, the degree of pain relief may lessen, and if the dosage is raised, side effects may worsen. This often leads people to seek out alternatives to opioids.

Those who have struggled with opioid abuse and addiction in the past often need to avoid opioids for pain management.

Herbs & Natural Remedies

Kratom is an herb that gained some popularity when the U.S. government tried to ban it in 2016. The efforts to ban this plant eventually failed, but some states do not allow companies to ship kratom to residents within the state.

Kratom is often used by people who are relief from pain. Some people who are addicted to opioids report that it may help to ease withdrawal symptoms during the detox period. Some researchers caution that people using kratom to replace opioids may find themselves dependent on kratom.

Kratom has two primary alkaloid compounds that are responsible for its effects.

Young Woman Taking CBD Oil Orally

They are 7-hydroxymitragynine and mitragynine. Both of these compounds attach to opioid receptors as heroin and prescription opioids do, and this allows for pain relief and a reduction in withdrawal symptoms.

CBD oil is another natural remedy that people say helps them with their pain. The research has not made a definitive statement on its efficacy, though some preliminary evidence suggests it may be beneficial for arthritis pain.

One study was performed to look at using CBD for opioid withdrawal. The study concluded that it might reduce cravings for opioids when someone is in recovery. The results were compared to people who received no treatment and those who got a placebo.

Injection Procedures

When back pain is moderate to severe, doctors often prescribe opioids to help people. About 20 percent of people who take opioids long-term develop a substance use disorder related to their use.

Some injection procedures may help with certain types of pain in the joints or back. For example, if someone has a herniated disc in the lower spine that is irritating nerves, an injection of steroids into the epidural space may alleviate the inflammation and reduce pain.

The following injection procedures may help people with back pain to reduce their need for prescription opioids:

EPIDURAL STEROID INJECTION

This procedure involves putting steroids directly around the nerve root sac (dura) to alleviate inflammation. These injections are successful for about 50 percent of people.

FACET JOINT BLOCK

This injection involves a steroid and a numbing medicine. In some cases, people get long-term relief from their pain.

SELECTIVE NERVE ROOT BLOCK

This type of injection can diagnose a specific nerve causing pain and help to relieve leg or lower back pain.

FACET RHIZOTOMY

This injection works to disable the sensory nerve going to a facet joint that is causing a person’s pain. The goal is long-term pain relief.

All of these procedures are typically done on an outpatient basis. Doctors use a type of x-ray called a fluoroscope to guide the needle to the precise area where the medicine needs to go. This ensures that it is delivered accurately, so the injection has the best chance of providing pain relief. Most of these injections can also be used to diagnose the source of a patient’s pain.

Other Pain Relief Treatments

A few other options may provide some pain relief, especially for those experiencing back pain. These include radiofrequency ablation, spinal cord stimulation, and transcutaneous electrical nerve stimulation.

RADIOFREQUENCY ABLATION

uses a needle that is guided to the nerve causing pain. Radio waves create an electric current that burns the targeted nerve. This can result in up to a year of pain relief. It is usually an outpatient procedure.

TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS)

involves a small device that can deliver low-voltage electrical signals to areas that are causing pain. This unit is ideal for muscle-related pain, and it can be used on different parts of the body.
To use it, the person will put the patches where their pain is concentrated and turn the machine to their desired level. The electrical signals may stimulate endorphin production to help alleviate pain.

SPINAL CORD STIMULATION

is another option. It uses a device that is like a pacemaker. It sends a sensation to the spinal cord to essentially replace the pain a person is experiencing.

PAIN PUMPS

are an option when other methods fail. These pumps are implanted, and the person can push a button as needed to send medication directly to their spinal cord. This may have fewer side effects than taking pain medications orally.
These pumps have limits in place so that people cannot give themselves too large of a dose. In most cases, smaller doses provide adequate relief from pain with these pumps.

Talk to Your Doctor

Consult with your doctor if you are considering using an alternative to opioids for pain relief. Your doctor will assess your situation and the substance you want to use, and determine if the benefits outweigh the risks.
If the alternative is deemed viable and safe, it may be a good solution to get you off opioids.

Most often, your doctor will recommend lifestyle changes that support pain relief. These might include regular exercise, physical therapy, yoga, meditation, and daily stretching.