Injuries that occurs to the musculoskeletal system, such as dislocations, fractures, breaks, and sprains are orthopedic injuries. They can range from uncomfortable to excruciating depending on the type. In the past, prescription of opioids were commonly used to treat the pain of these injuries. However, the risk of opioid addiction from orthopedic injury has led to a change in pain management practices in recent years.
Opioids are very good for pain management because they stop your pain receptors from telling your brain that you’re hurting. If the pain is simply a part of your healing, and not an indicator of further injury, it made sense to use opioids to manage a patient’s discomfort during this process.
However, opioids carry a high risk of abuse and addiction. There are two fundamental reasons for this. Firstly, opioids target the reward center of your brain. In addition to shutting down the transfer of pain-related data from the injury site to the brain, they make you feel extremely good.
Secondly, it’s very easy to build up a tolerance to opioids. The initial dosage may have shut down pain data and gave you a euphoric lift. But over time, this dosage will produce a lower and lower euphoric response and may not even control your pain. This means that you need a higher and higher dose to produce the same result. To continue to feel good, you must chase the high. This chasing of the next “buzz” or euphoric response is the basis of addiction.
When suffering from an injury, your brain is continually receiving and sending a pain response. Your muscles may seize up around the injury, making stretching out in physical therapy or on your own extremely difficult. Often the healing process in physical therapy leads to more pain and suffering in order to heal effectively.
Endorphin Release Effects
When we exercise, endorphins are released. This is the rush after a workout that makes you feel great. Endorphins are also released when we take opioids, which is one of the reasons they are so appealing. The problem is that over time that release is lessened. If you are injured and can’t exercise to boost your endorphin output, opioid intake must increase to get the same good feeling.
To this end, opioids are doubly destructive. They cause an endorphin release, but over time the body reduces that release, so you need more opiates to get the same rush. Because your natural endorphin release system is suppressed by the opiate dosage, your natural endorphin level doesn’t just dip, it plummets.
When the Opioids Stop
Withdrawal from any mood-altering substance is brutal, but opioid detox is particularly challenging. Even more so with a chronic orthopedic injury, as the pain from the injury returns along with a myriad of other problems related to opioid withdrawals and addiction. Aside from physical symptoms, there are the mental effects that injury can bring. Your injury may never recover to the same standard that you had before.
Thus, in the case of injury, withdrawal is about more than physical pain. Your life is different. If you were part of a team, you find yourself losing a major source of social connection. You still have to work through physical therapy to try to build up range of motion and strength, so your schedule has changed and your work life may be altered.
Finally, those feel-good endorphins have been suppressed by the opiate painkillers, so you’re likely feeling emotionally low, even as your physical pain has decreased.
After the acute phase of an injury is over, the doctor typically stops prescribing opioid painkillers. For someone who has built a tolerance or become addicted to opioids, this becomes a problem. Often to deal with their pain or feed their addiction, people will go to the streets in search of their fix. Unfortunately, street prices of prescription opioids can be staggering, leading people to use a cheaper and even more dangerous alternative, heroin. This pattern has played out many times and is a major contributor to the United States’ ongoing opioid crisis.
Opioid addiction is highly dangerous. If you are struggling opioid addiction after an orthopedic injury, it is critical that you seek professional help. Contact us anytime, our caring staff can talk you through your concerns, discuss options with you, and ultimately help you get back on track.