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How to relieve pain without opioids

Steven Severyn, MD

Health and Wellness Neurological Institute Integrative Medicine

For the past couple of decades, prescription opioids such as oxycodone, hydrocodone, codeine, and morphine have been popular choices for helping patients to manage acute pain.

In fact, in 2016 there were more than 214 million opioid prescriptions in the United States, according to a report by the Centers for Disease Control and Prevention.

But as the rates of opioid abuse and overdose deaths have escalated in recent years, so have the concerns of those prescribing and taking these drugs. Both healthcare providers and patients are looking for other pain relief options.

Are non-opioid drugs as effective as opioids?

Opioids have long been considered the “go-to” drugs to help manage acute pain. For some acute conditions though, opioids are probably not necessary. A recent study in the Journal of the American Medical Association showed that opioid drugs (oxycodone, hydrocodone, or codeine) when combined with the non-opioid painkiller acetaminophen (Tylenol), were not more effective than a combination of non-opioid painkillers such as acetaminophen or ibuprofen (Advil) in reducing pain.

Acetaminophen can be helpful in treating acute pain associated with headache, arthritis, and cancer. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and aspirin are effective at controlling pain and also reducing fevers and inflammation.

What are other effective methods to treat pain?

The importance of regular exercise and of physical therapy is especially well established. Many people are now trying complementary and alternative medicine for pain management, rather than relying on drugs to provide relief.

Various studies have shown the benefits of using non-drug treatments such as acupuncture, aromatherapy, biofeedback, chiropractic, cognitive behavioral therapy, hypnotherapy and massage to help relieve chronic pain.

Some people find that their pain improves when they can reduce stress by using various relaxation techniques, such as guided imagery, progressive muscle relaxation and meditation. Others find relief by doing yoga on a regular basis.

What does Ohio State offer for pain management?

The Ohio State University Wexner Medical Center’s Comprehensive Pain and Headache Center provides management alternatives for patients whose pain results from chronic conditions other than cancer or spinal injury or disease.

These may include advanced arthritic pain of the hips or knees, pancreatic and other abdominal pain; chronic kidney and bladder pain; chronic regional pain syndrome; facial pain; migraine and other chronic headache conditions.

Our pain medicine experts may use advanced procedures such as sacroiliac radiofrequency nerve ablation, neural field stimulator implantation for non-spine painful conditions, radiofrequency ablation of other peripheral sensory nerves, and in a few select cases intrathecal drug delivery implantation for non-spine pain conditions.

As a part of our opioid reduction program, clinic physicians create a coordinated treatment plan to discontinue pain medicine over 60-75 days through a combination of medicine schedules, procedures, and referral to other therapies and substitution of medicines.

The Comprehensive Pain and Headache Center is a core component of the Ohio State’s Wexner Medical Center’s Neurological Institute which is working to develop new technologies and better treatments for people with complex pain and headaches.

Dr. Steven Severyn is an anesthesiologist and director of the Comprehensive Pain and Headache Center at The Ohio State University Wexner Medical Center’s Neurological Institute

Study Eases Fear Around Birth Control Side Effects

Evidence does not support a link between hormonal contraceptives and depression

Ohio State University Wexner Medical Center

COLUMBUS – The vast majority of women will use some method of contraception during their lifetime. Despite there being 37 million in the United States who are currently on birth control, many still worry about potential side effects. Depression is a common concern for many women, but a new study by researchers at The Ohio State University Wexner Medical Center is putting patients at ease after finding that there is no evidence to support a link between hormonal birth control and depression.

“We live in a media-savvy age where if one or a few people end up having severe side effects, all of a sudden, that really gets amplified to every single person,” said Dr. Brett Worly, lead author of the study and OB/GYN at The Ohio State University Wexner Medical Center. “The biggest misconception is that birth control leads to depression, and for most patients that’s just not the case.”

Worly and his team reviewed thousands of studies on the mental health effects of contraceptives that included data tied to various contraception methods, including injections, implants and pills. Researchers found that the evidence does not support an association with depression. Similarly, researchers reviewed studies examining the effects of hormonal birth control on postpartum women, adolescents and depressed women, all with the same conclusion: there is insufficient evidence to prove a link between birth control and depression.

Experts say women should continue to have open and honest discussions with their doctors to decide what is best for them. “In the past, some of my patients have worried that birth control will lead to depression,” said Worly, “but based on our findings, it shouldn’t be a concern for most women and they should feel comfortable knowing they’re making a safe choice.”

Many women worry about the potential side effects of hormonal contraceptives, including depression. However, researchers at The Ohio State University Wexner Medical Center conducted a comprehensive review of current research and found there is not sufficient evidence to link birth control and depression.

Dr. Brett Worly led a study at The Ohio State University Wexner Medical Center that found there is no substantial evidence to prove a link between hormonal contraceptives and depression.

Gina Carlomagno was concerned about the potential effects of hormonal birth control on her mental health, but after comparing data from thousands of studies, researchers at The Ohio State University Wexner Medical Center found there is no link between contraceptives and depression.

Carlomagno takes birth control daily. Initially, she worried that the pill could affect her mental health, but a new study at The Ohio State University Wexner Medical Center found no link between hormonal contraceptives and depression. Carlomagno, 31, says she feels safe knowing that her birth control won’t affect her mental health. Researchers at The Ohio State University Wexner Medical Center compared data from thousands of studies and found no link between contraceptives and depression.

Attorney General DeWine Files Lawsuit Against Opioid Distributors for Distribution Practices which Fueled Opioid Diversion

COLUMBUS — Ohio Attorney General Mike DeWine today (Feb. 26) filed a lawsuit against four major prescription opioid distributors in Madison County Court of Common Pleas. The lawsuit alleges that the drug companies engaged in unsafe distribution practices that ignored their responsibility under law to provide effective controls against opioid diversion.

“We believe the evidence will show that these companies ignored their duties as drug distributors to ensure that opioids were not being diverted for improper use. They knew the amount of opioids allowed to flow into Ohio far exceeded what could be consumed for medically-necessary purposes, but they did nothing to stop it,” said Ohio Attorney General Mike DeWine. “And much like the drug manufacturers who continue to fail to do the right thing, these distributors are doing precious little to take responsibility for their actions and help pay for the damage they have caused.”

The four distributors which are listed as defendants include:

  • McKesson Corporation
  • Cardinal Health, Inc., and its subsidiaries
  • AmerisourceBergen Drug Corporation
  • Miami-Luken, Inc.

The lawsuit alleges, among several counts, that the drug companies were negligent and created a public nuisance by using unsafe distribution practices and by irresponsibly oversupplying the market in and around Ohio with highly-addictive prescription opioids. The companies are alleged to have failed to act upon their responsibilities under both federal and Ohio law to stop such orders that would result in oversupply and report these suspicious orders to the United States Drug Enforcement Agency (DEA) and the Ohio Board of Pharmacy. The lawsuit also alleges that the companies should have known that the volume of opioids supplied far exceeded what could be responsibly used in markets in Ohio and would likely have contributed to the opioids being illegally diverted and abused. This behavior directly fueled the opioid epidemic Ohio is currently facing.

In the lawsuit, Attorney General DeWine is seeking a number of remedies including punitive damages as well as compensatory damages for costs incurred by Ohio for its increased spending for healthcare, criminal justice, social services, and education. The lawsuit also seeks to enjoin the defendants from further improper conduct by complying with reporting requirements for suspicious orders and to undertake more complete reporting of suspicious orders to the DEA and the Ohio Board of Pharmacy as well as the Ohio Attorney General’s Office.

The lawsuit was filed in Madison County, which has consistently had a higher number of opioids distributed to it than the statewide average. In 2016, the last year for which data is available, an average of more than 76 opioid doses was distributed for every man, woman, and child in Madison County, a rate that was 39% higher than the Ohio statewide average for that year.

A copy of the lawsuit is available on the Ohio Attorney General’s website.

Staff Reports

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