Tapering Off Prescription Opioids: Tips for Success

By Naturally Savvy

Beth Darnell, author of Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control over Chronic Pain joined Andrea Donsky and Lisa Davis on Naturally Savvy Radio to discuss prescription opioids and how to come off them safely. [The following transcript has been edited for print.]

Listen to the full radio interview here.

Lisa Davis: The opioid epidemic in America is absolutely shocking and heartbreaking. We really need to be able to help people and help them help themselves. We are going to be talking about tapering off prescriptions opioids, with Beth Darnall.

When speaking about the opioid epidemic, I think both about people who are using heroin, and also people who are using prescription medications. Beth, talk to us about some of the differences that you’ve seen with heroin or prescription opioid abuse.

Beth Darnall: There’s a big focus on opioid deaths in the United States. In 2014 alone there were almost 30,000 people who died from unintentional overdoses related to opioids. What we want to do is take a look at why these opioids are flooding America and what is happening with over-prescription. Opioids are prescribed after surgery and they’re also prescribed for chronic pain. What we’ve seen in the past 10 to 15 years is skyrocketing rates of prescribing opioids long-term for chronic pain. This is something that is now a focus of change in the United States. What we know is that chronic pain is not best treated by pill alone. In fact, the CDC has become involved and has recommended that opioids actually be avoided for chronic pain and that they only be prescribed for one week after surgeries and medical procedures. This is something of a sea change. But, if we’re not going to be giving people opioids, how are we going to treat their pain?

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Andrea Donsky: I would think that opioid use is coming under scrutiny because of all the deaths that have been related to it. For example, with the musician Prince, who I believe died from opioid abuse.

Beth Darnall: The coroner’s report came out and opioids were indeed a major contributing factor in Prince's death. It’s been stated that he had hip surgery and was on long-term opioids for that. It’s a slippery slope where people can be prescribed opioids for a number of reasons and individuals develop tolerances to them—it’s a physiological phenomenon that happens with everyone. It’s different than addiction—it’s physiological tolerance where you need more medication over time to “gain pain relief.” These escalating doses of opioids place individuals at risk for lots of different side effects and indeed death. We really want to focus on treating pain in a way that minimizes risk.

Now, the problem with the CDC guidelines is that they actually don’t offer any alternatives for pain. The CDC guidelines simply say: don’t focus on opioids. But that doesn’t really help the 100 million Americans who are living with ongoing pain. We need to treat pain better. So just taking away opioids is one part of the equation, but it really doesn’t address this fundamental problem. In fact, it’s caused a lot of distress among patients living with chronic pain who feel that their medication is being taken away from them now.

Andrea Donsky: My husband, a couple of years ago, had a herniated disc in his back and he was in so much pain, it radiated literally into every part of his body. He was watching Sanjay Gupta on CNN and he was, at that time, on prescribed opioids, and he watched Sanjay Gupta talk about the fact that you become addicted to them. That day he came to me and said, “I can’t be on this for another day. I need to find an alternative.” And I’ll tell you, he found alternatives that helped with his pain. It might have taken a little bit of time because it didn’t take the edge off immediately, but we found there are anti-inflammatory supplements like curcumin and omega 3’s. Serrapeptase is something that I’ve been using because I get a lot of back pain and it’s really helped to take the edge off that pain that I suffer from chronically. I’d love to hear your opinion on what are some of the best options for managing pain.

Beth Darnall: There are a multitude of medications that may be helpful for pain that are non-opioid. If we’re talking about medications, then I strongly encourage people to speak with their pain physician about the other medical options because they will likely have a much lower risk profile. The big message that I like to deliver is that pain isn’t just a sensory experience. It’s not just the hurt that we feel in our bodies. Pain is defined as a negative sensory and emotional experience. What that means is that psychological factors are built into our pain experience and they profoundly influence how we respond to pain—how distressing it is; how intense it is; whether or not it gets better. It is mindboggling how important an individual's psychology is in determining how much they suffer from pain.

I am a Behaviorist and focus on helping people learn pain management strategies (or, pain psychology skills) so that they can learn to calm their own nervous system. What that does is dampen pain processing in the brain and in the spinal cord. That translates into not only less pain, but less need for any medication, and certainly less need for opioids. It’s really a pathway of self-empowerment. I’d also like to mention that physical therapy—movement, appropriate exercise—these play a critical role in pain relief. It’s under-appreciated because most individuals think, "wow when I move it hurts, so I should stop moving." That’s a natural association to make, but over time, that deactivation can actually lead to greater and greater pain—it’s counterintuitive.

Lisa Davis: My mother suffered with chronic pain for years from botched knee surgeries in the early ‘70’s. She ended up with fibromyalgia and some other autoimmune diseases, and it was just soul crushing. She used to swim all the time and then she stopped. She did that thing you just talked about, and it was so difficult for her. You talk about you need to plan to taper off of opioids—your life has to be calm when you start getting off them. Tell us about that.

Beth Darnall: One of the biggest messages I’d like to give is that often people try to get off opioids themselves and were unsuccessful. They experienced withdrawal symptoms and they thought, "okay I just simply can’t get off, I need to stay on the medication." And that is simply not true. If you go slow enough and if you adopt a very slow, rational tapering plan, you can get off opioids if you want to. So talk to you doctor. Ialso provide a lot of supportive tips in my book, 
Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control over Chronic Pain.

Listen to the full radio interview here.

If you would like to learn more about Beth Darnall, visit BethDarnall.com
, or follow on Twitter @BethDarnall.

READ MORE: Mindfulness Meditation to Chase Away Pain

By Naturally Savvy| August 27, 2016
Categories:  Care

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Naturally Savvy

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