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Chasing the Dragon: Driving the Paradigm Shift to Move Beyond Opioids
1University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, Baltimore, MD.
The Journal of Orthopaedic and Sports Physical Therapy
|October 20, 2020
Summary
The pursuit of passive pain relief with opioids is dangerous. Prioritizing exercise and physical rehabilitation as first-line treatments can reduce opioid use and save lives.
Area of Science:
- Pain Management
- Public Health
- Musculoskeletal Conditions
Background:
- The term "chasing the dragon" historically refers to opium use and now metaphorically describes the elusive goal of rapid, effective, and safe passive pain treatment.
- The United States faces a severe opioid crisis, partly due to a cultural expectation of quick, physician-provided pain relief.
- Pharmaceuticals cannot cure injuries or underlying causes of chronic musculoskeletal conditions.
Purpose of the Study:
- To challenge the reliance on passive, pharmaceutical pain management.
- To advocate for exercise and physical rehabilitation as primary pain treatment strategies.
- To highlight the potential of opioid-naïve approaches in reducing opioid-related harm.
Main Methods:
- Review of current pain management practices and cultural attitudes towards pain relief.
- Analysis of the effectiveness of exercise and physical rehabilitation versus passive care.
- Examination of the impact of first-line pharmaceutical pain management on the opioid crisis.
Main Results:
- Regular exercise is associated with reduced pain.
- Guidelines increasingly recommend exercise therapies over passive care for painful chronic conditions.
- Early guided physical rehabilitation is linked to lower healthcare costs and reduced opioid medication use.
Conclusions:
- Self-care approaches centered on exercise are the most logical, cost-effective, first-line treatment for pain.
- A shift in attitudes, behaviors, and policies is necessary to move away from first-line pharmaceutical pain management.
- Prioritizing exercise and physical rehabilitation can significantly reduce opioid dependency and save lives globally.
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