“Opioids are appropriate for cancer, end-of-life and short-term pain, but they never should be used as a first-line treatment for ongoing pain,” says F. Michael Ferrante, MD, director of the UCLA Comprehensive Pain Center. 2 grams per day for chronic use. the number dying from illegal drugs,” notes Michael Sniderman, MD, a UCLA pain- So-called interventional procedures can also management specialist in Torrance. (UCLA Anti-inflammatory drugs provide relief. Depending on the source of the Health also has community-based pain pain, these can include facet joint injections clinics in Santa Clarita and Thousand Oaks.) Acetaminophen (no more than as well as injections that block the responsible 2 grams per day for chronic use) nerves from sending pain signals — in some Dr. Ferrante says that patients who seek opioid cases in conjunction with radiofrequency medications tend to fall into four categories: ablation, which uses electrical currents to those who can use them effectively on a heat targeted areas in an effort to further long-term basis to improve their quality of decrease “Over the life with no major complications; those who Facet joint injections the signals. doctor’ the role years, grown ‘interventional pain has develop opioid-induced hyperalgesia, needing Blocks the responsible significantly from nerves as problems associated with increasingly higher doses; those who become sending pain addicted and in need of rehabilitation; and signals opioid medicines have become better appreciated,” Dr. Sniderman says. those who should never receive the drugs. Approximately 25-million adults in the U.S., one-in-nine, have experienced some ongoing form of pain, according to the National Health Interview Survey. Beginning in the late 1980s, opioid medications began to be prescribed for many types of chronic pain. But that Nearly has half of as all opioid thinking changed awareness of addiction has increased. “The number of people overdose deaths involve dying from overdoses of prescription medications a is prescription higher than now considerably opioid Some patients can benefit from nonopioid medications such as anti-inflammatory drugs, particularly patients with bone pain, Dr. Ferrante notes. Acetaminophen can also be used, but in moderation — no more than In response to a national epidemic of prescription opioid addiction, the U.S. Centers for Disease Control and Prevention has issued guidelines designed to reduce inappropriate prescribing of narcotic drugs for noncancer chronic pain. UCLA Health pain-management specialists note that non-narcotic approaches to treating chronic pain not only are safer, but also in many cases more effective. 1- in -9 adults have experienced some ongoing form of pain Nonopioid medication options Interventional procedures In 2015, opioids killed “An evaluation that includes Radiofrequency Drs. ablation and Ferrante note that these Sniderman experts in pain, more than interventional procedures, coupled with addiction and psychiatry can help to determine physical therapy and/or occupational therapy, into which category a patient falls. You have to significantly reduce pain improve tailor the alternatives based on the underlying Physical therapy and and/or people cause of the pain,” Dr. Ferrante says. occupational can make therapy for patients function. “We it easier to do the kinds of physical therapies and 33,000 exercises that might heal them for the long term,” he says. Psychological Says and Keith Heinzerling, MD, addiction- medicine physician with complementary treatments the UCLA Center Source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention Vital Signs Fall 2017 Vol. 76 5