Opioid-Related Hospitalization Rises For Chronic Disease Sufferers Published February 20, 2020 By Addiction Helpline America

CDC Studies Opioid-Related Hospitalizations

Opioid-related hospital stays have steadily risen over the past few years. This rise has been attributed to opioid abuse, addiction, and poisoning. In the US, the number of chronic diseases reported have also risen, with 1 in 4 adults living with 2 or more chronic diseases every day. Since opioids are commonly prescribed to these chronic disease patients, researchers examined the association between patients with chronic diseases, and opioid-related hospitalizations. Study results were published in the Centers for Disease Control and Prevention (CDC) journal Preventing Chronic Disease:

“We found that more than 90% of opioid-related hospitalizations were among patients with 2 or more chronic diseases and that the trend in opioid-related hospitalization among patients with chronic diseases is increasing. This finding is salient given that 1 in 4 US adults are living with 2 or more chronic diseases. Both the opioid crisis and rising rates of chronic disease have been described as epidemics; however, they are currently being treated separately. The US Department of Health and Human Services’ 5-point strategy to combat the opioid crisis focuses on the treatment of addiction, which is important for addressing the epidemic in the short term. A population-level approach to preventing and treating chronic diseases is also needed. Health services must address the 2 issues — opioid misuse and management of chronic disease — simultaneously.”

Over 3 million hospitalizations for opioid abuse, addiction, and poisoning between 2011 and 2015 were analyzed by researchers. It was found that patients with chronic conditions including asthma, spinal disease, obesity, liver disease, and cancer were most likely to have their pain treated with opioids.

Many of the patients were Caucasian, age 35 to 54 years, received care in urban hospitals, and had been diagnosed with 2 or more chronic conditions. The statistics also showed the number of opioid-related hospitalizations were equally divided between men and women.

Statistically, opioid-related hospitalizations were most common in urban-area hospitals by people on Medicare and Medicaid.

Asthma was the number one condition most associated with hospitalization, followed by obesity, and then liver disease. There was a significant association between the presence of chronic disease and the prescription of opioids by a doctor to treat the associated pain. This was true for every year researchers studied.

The Rise of Chronic Disease and the Opioid Epidemic

While rising chronic disease rates and the opioid addiction crisis have been called epidemics, they are treated as separate issues within the US healthcare system. Researchers suggest that these epidemics should be treated concurrently. Medical researchers suggest that pain management for patients with chronic diseases could be addressed using alternative methods. Non-pharmacologic interventions, such as exercise and cognitive behavioral therapy (CBT), could help to reduce the number of opioids prescribed to chronic disease patients.

While the study could prove to change the way chronic disease symptoms are managed, the data researchers gathered was limited in scope to a relatively short period of time. Other limitations include the lack of controlling for covariates, and the small number of chronic diseases researchers studied. The study did not consider any mental health conditions, which were omitted from the gathered data.

The findings of the study show that patients with 2 or more chronic conditions exhibit a high prevalence for opioid-related hospitalization. It goes on to recommend that these patients should be provided with alternative interventions to educate them on the potential for opioid misuse.

Alternatives to Opioid Medication

The first commonly overlooked alternative to opioid medication for pain are over the counter (OTC) pain medications. These include aspirin, acetaminophen, and ibuprofen. In addition, there are non-opioid prescriptions to help with pain such as steroids. These common, safe, and accessible options are often overlooked because people assume that they need something stronger when diagnosed with a chronic illness. Other people find relief with nondrug therapies that can be used alone, or in combination with medications.

Traditional Non-Drug Therapies as An Alternative to Opioids

Non-drug therapies include:

• Physical Therapy – This type of therapy is performed by a therapist or physician who specializes in physical medicine and rehabilitation. The health care creates an exercise program designed to help the person improve their ability to function and decrease pain.
• Surgery – In some cases, surgery can be performed to correct abnormalities in your body that may be responsible for your pain.
• Injections or nerve blocks – For muscle spasm or nerve pain, injections of a local anesthetic or other medications can help to relive pain from chronic conditions.
• Acupuncture – Acupuncture is a form of alternative medicine and a key component of traditional Chinese medicine in which thin needles are inserted into the body. It is believed acupuncture can interfere with pain signals, causing relief from the pain of some chronic disease symptoms.
• Massage - Many patients find relief from massage and other relaxation techniques.

Modern Non-Opioid Pain Relief Therapies for People with Chronic Pain

Sometimes, the combination of non-opioid medication and traditional therapies do not relieve a patient’s pain. Because of this, new techniques are always being researched and developed to relieve chronic pain in people suffering from chronic conditions and diseases. Many researchers believe the implementation of these next-generation methods could help to reduce the number of opioid-related hospitalizations by reducing the overall number of opioids prescribed to patients with chronic diseases.

Here are some of the latest methods:

• Pain pumps –A pain pump can be implanted which allows a patient to have pain medicine delivered their spinal cord with a push of a button. This device gives the patient relief without the side effects that come with taking drugs orally. This device gives the patients direct control over their pain, which has shown to be beneficial. Spinal drug pumps are most frequently used by people suffering with pain from cancer, and by patients who experienced side effects when taking their medication orally.
• Radio waves –Radiofrequency ablation is the process of inserting a needle next to the nerve responsible for the patient’s pain. An electric current created by radio waves short-circuits the pain signal. This type of pain relief can be effective for up to a year.
• Electrical signals –Transcutaneous electrical nerve stimulation can provide short-term pain relief. This method is primarily used to treat muscle pain with low-voltage electrical signals. The signals are sent from a small device through pads attached to the skin over the affected muscles. Researchers are still trying to interpret how it works, they believe it may either interrupt the nerve signals to the brain or stimulate the production of endorphins. Endorphins are the body’s natural painkillers.
• Nerve blocks –Using this method, doctors can inject a numbing medication to block or dampen a pain in a patient suffering with a chronic condition. This method is being investigated to stop chronic pain from developing in the first place. The location of the injection depends on the source and type of pain. Relief may require a series of injections and multiple treatments.
• Spinal cord stimulation –Commonly a “last resort”, a pain medicine specialist may recommend spinal cord stimulation (SCS). This pain relief method uses a device, like a pacemaker, that replaces the pain with a more tolerable sensation. The result is a tingling or massage-like feeling instead of pain. The device is implanted in the lower back and attached to wires that are implanted in the spinal canal. The patient can use a remote control to send signals to the painful area.
• Stem Cell Research –Harvesting stem cells from a patient’s bone marrow and injecting them into an area that has become painful due to deteriorated tissue is an emerging science that promises to help with chronic pain. The hope is that the stem cells will build new, healthy tissue and permanently relieve the pain.

Addiction Treatment for People with Chronic Illnesses

People who live with chronic conditions, especially those with chronic pain, are used to having their motives questioned by their medical providers when seeking medication. Doctors have the difficult task of determining if their patients are seeking opioid-based medication due to a substance abuse disorder, rather than pain relief for symptoms of their chronic illness or condition.

The journey to wellness should always begin with a doctor who listens to you and understands your chronic condition. An important part of seeking help for an addiction when you have a chronic illness is to be honest about your addiction history.

Talk to your doctor about the best way to manage your disease without furthering your addiction. If you find yourself abusing your medication, or adopting new addictive behaviors, you must tell your doctor immediately. Depending upon your condition, you may be able to alternate between different medications designed to do the same things, which could help to reduce the risk of dependency.

If it is determined that you need help with an addiction while suffering from a chronic illness that requires pain medication, seek help immediately. The level of addiction care you can choose may be affected by your condition. Many times, people with chronic illnesses opt to receive addiction treatment in facilities that offer a higher level of care. Rehabs offering ASAM Level 4 care, referred to as Medically Managed Intensive Inpatient Services for adolescents and adults. This level of care offers 24-hour nursing care and daily physician.

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