The Wisdom of Developing Opioid Alternatives

What leads to chipmunk cheeks, smoothies without straws, and extreme Jell-O consumption? If you guessed recovery from wisdom teeth removal, you are right. Both of my teenaged children had theirs out in the past year. The oral surgeon provided specific post-op pain management instructions, which focused on alternating doses of over-the-counter (OTC) ibuprofen and acetaminophen. And, we were given a short-term prescription for oxycodone to use if needed. This stopped me in my tracks. Just how bad would this pain be? Is this how opioid addiction starts? Do I want my teenagers to take something like this and risk going down a path of no return? Am I a bad mom for withholding this medical option and risking undertreating their pain, causing unnecessary misery?

While this may sound dramatic, addiction to pain medication impacts people of all walks of life, and in many cases, addiction starts with a specific pain event that ends up spiraling out of control. I could not assume that my children are immune to this phenomenon, even under my watchful eye. It’s easy to see how the conundrum begins—the options for pain management, especially for short-term issues such as outpatient surgery and injuries, are limited. Patients need something in between OTC pain relievers that are used for so many everyday aches and pains, and opioids, which carry so many risks.

Escalent’s Health team conducted a survey among US adults suffering from either short-term or chronic pain, and we found that approximately 60% have used OTC medication and 47% have used prescription medication to manage the pain. Furthermore, of those taking pharmacological treatments, 71% of those with chronic pain and 55% of those with short-term pain are taking opioids.

How might their lives be improved by having more options? What if there were effective prescription medications available that do not carry the risk of addiction? Generally, consumers are open to other options—we found that nearly two-thirds would be likely to try alternatives if they were as effective as currently available prescription medications—but currently there are few alternatives as convenient and potent as opioids. One possible opioid alternative, cannabidiol (CBD), appears to have some impact on pain relief, but the clinical data are sparse and the product is largely unregulated.

In the US, most new medical developments come by way of investments by pharmaceutical companies working to achieve FDA approval via robust clinical trials. Treatments that are developed outside this model, such as herbal supplements, struggle to gain widespread acceptance in the medical community.  It’s time for pharma to make significant investments in research to find safer alternatives to opioids that deliver comparable efficacy. Although we all have to take risks in life, risks in pain management should not be one of them.

Fortunately, both of my children recovered from their oral surgery within a few days and their misery was contained. Let’s hope that by the time their own children undergo this procedure, oral surgeons will have better pain management options to offer.