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Writer's pictureDr. Mike Skaliy

Safe, Effective Alternatives to Opioids for Back Pain


We’ve all heard about the “opioid epidemic” in the United States. But is it really an “epidemic,” and how do we know? The short answer is: “yes.” There is an ongoing epidemic of overuse, overprescribing, and misuse of opioid medications in the United States, and our country is paying a heavy price. According to the U.S. Department of Health and Human Services (HHS), nearly 91 Americans die from opioid overdoses every single day. Countless other people struggle with addiction, and many of these still live with frequent or chronic pain.


I’ve been successfully treating patients in pain for more than 30 years, and I’m here to tell you, it doesn’t have to be that way. There are safe, effective treatments available without opioid drugs. Patients just need to be made aware of these options. This isn’t about placing blame, pointing fingers at desperate patients living in pain and the well-meaning doctors who want to help them. Many of us had legitimate concerns about opioid medications, and we raised them decades ago. These concerns were answered with false promises.


How False Promises Lead to a Real Crisis

Back in the 1990s, physicians contacted pharmaceutical companies, raising serious concerns about the nature and risks of opioid medication. These doctors were not against pain medications, even opioid drugs. They fully accepted that, under strict guidelines, opioid medications can be effective short-term pain relievers. However, these doctors also understood the potential for abuse. Pharmaceutical companies dismissed these concerns, promising these well-meaning doctors that their patients would not become addicted to opioid pain relievers.


As a direct result of these promises, acting in good faith and for the benefit of their patients, more doctors began prescribing opioid pain relievers at greater rates. Increased opportunity opened the door to increased potential for misuse of these medications, and the addictive nature of these drugs led to widespread misuse of both prescription and non-prescription opioid drugs. While some people were being helped, many others were descending into a spiral of addiction that would consume them and hurt everyone around them in the process.


Two decades after those false promises, the acting secretary of the United States Department of Health and Human Services declared opioid misuse an official “public health emergency,” calling on doctors to support a federal plan to teach patients about medically-proven alternative treatments to chronic pain, including back pain and sciatica, and to help people who have fallen victim to opioid addiction.


America in Crisis?

While many doctors accepted the shared responsibility to help patients and offer effective, non-addictive pain treatments, some health care providers continued prescribing highly-addictive opioids at rates known to be unsafe. Today, enough opioid medications are being written each year for “half of all Americans to have one.”

Do 165 million Americans really need opioid drugs? The answer to that is obvious, even before you learn that patients receive more than twice the volume of opioids considered appropriate when these concerns were initially raised back in the ‘90s. Unfortunately, according to the CDC, “many physicians regularly ignore federal guidelines, prescribing large quantities of powerful opioid medications even when better treatment options are available…”


Knowing this, you might wonder if this increase in opioid prescriptions in the United States is on par with what is happening in other modern, first-world nations? No. It’s not. While the United States makes up about 5 percent of the world’s population, Americans consume about 80 percent of the world’s prescription opioids. While opioid abuse is certainly present in other countries, this significant level of misuse is mostly an American problem.


This is just one of the negative side-effects of over-prescribing opioid pain medication. Many times, when people can no longer buy legal prescriptions, they obtain illegal narcotics such as heroin and black-market Fentanyl to feed their addiction. This leads otherwise law-abiding citizens down the road into active participation in the illicit drug trade, which brings physical and emotional danger, as well as financial and legal difficulty, to themselves and their families.


And there’s another byproduct of overprescribing opioid painkillers: too many surplus doses in circulation. Open countless medicine cabinets in the United States, and you will find an unused reserve of highly-addictive, potentially-deadly medication waiting to ensnare another victim. This reality puts tens of millions of Americans at risk of addiction.


In response, both HHS and CDC have asked physicians to look at other proven treatment alternatives to help their patients obtain an improved quality of life without highly-addictive drugs. Unfortunately, many health insurance companies, which gladly pay for opioid medications, have also limited their reimbursements for non-opioid treatments. So, people, desperate for hope and for help, agree to the drugs. Sometimes the drugs help, and sometimes patients are able to stop when the pain has subsided. Other times, the reward for their hope is addiction… even after the drugs stop working.


A Better Solution

Patients frequently come to my practice looking for a pain-relieving alternative to prescription opioid drugs. They tell me they’ve been on these addictive pain medications for months or even years, but their quality of life isn’t any better. I listen to their stories, to the pain and heartache. While I’m glad they have come to me, and I do my best to help in any way I can, I often wish they had come sooner.


Because — and here’s the good news — in most cases, the patients I see do have options. As an interventional pain physician with more than 30 years of experience helping patients overcome chronic pain, including lower back pain and sciatica, we have treatments that can get patients off opioid drugs and get them back to a quality of life that includes all the activities they used to love before the pain took over.


To learn more about these minimally invasive, non-addictive treatments for back pain, click here to schedule an appointment where we will discuss your specific situation and review your treatment options.

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