Analgesic

Definition: Drugs that relieve pain without altering consciousness.

Comment/Importance to Caregiving:

  • Analgesics are often part of the treatment plan, especially when pain is moderate or severe

Non-Drug Pain Management

Definition: Nondrug Treatments include activities or experiences that help provide relief of physical and psychological symptoms of pain either with or without the use of medications, or in addition to, the use of medication.

Comment/Importance to Caregiving:

  • There are two categories of nondrug treatment techniques:                                                
    1. Physical
    2. Psychological
  • Examples of physical nondrug techniques:
    1. Massage
    2. Cold
    3. Heat
    4. Positioning
    5. TENS
    6. Acupuncture
    7. Tai Chi
    8. Yoga
    9. Walking
    10. Qigong
  • Examples of Psychological nondrug techniques:
    1. Distraction
    2. Relaxation
    3. Music
    4. Controlled breathing & guided imagery
    5. Mindfulness-based Mediation
    6. Cognitive-Behavioral Therapy
  • Mild-to-moderate pain may be relieved by nondrug techniques alone
  • Moderate-to-severe pain may require medication in addition to nondrug treatment techniques
  • Some nondrug techniques may require professional oversite to perform (see FAST FACTS- Caregivers about Nondrug Treatment Techniques)

Opioid Therapy

Definition: A class of drugs used to reduce pain, generally prescribed to treat moderate to severe pain, that works by interfering with the perception of pain in the brain

Comment/Importance to Caregiving:

  • Understanding the pain your loved one is experiencing helps you share important information with your loved one’s healthcare provider that can help to guide the treatment plan
  • Helping your loved one to Maintain a Daily Pain Dairy is an excellent way to share information with the healthcare team about your loved ones’ pain experience (see the FAST FACTS- Caregivers: Using a Pain Diary)

Opioid Use Disorder

Definition: A problematic pattern of opioid use that causes significant impairment or distress.

Comment/Importance to Caregiving:

  • Used to be called addiction, but now diagnosed as Opioid Use Disorder
  • Opioid Use Disorder is uncommon among people living in nursing homes being treated for pain
  • Tolerance and physical dependence are normal physiologic responses to chronic medication administration, whereas Opioid Use Disorder is a disease that is not a normal response to opioid use
  • Opioid Use Disorder is more likely to occur in older adults with multiple risk factors, such as a genetic predisposition, a history of addictive behavior, or a history of abuse and/or neglect
  • It is recommended that pain be adequately controlled before reaching conclusions about concerns related to Opioid Use Disorder behaviors
  • An individual’s behaviors that may suggest Opioid Use Disorder (OUD) sometimes reflect unrelieved pain or other problems unrelated to OUD, you should report all behaviors to your loved ones’ healthcare team for evaluation

References:

https://www.cdc.gov/opioids/; Accessed 1/16/2019

Definitions Related to the Use of Opioids for the Treatment of Pain: a consensus document from the American Academy of Pain Medicine the American Pain Society, and the American Society of Addiction Medicine, 2009. 

Public Policy Statement on the Rights and Responsibilities of Healthcare Professionals in the use of Opioids for the Treatment of Pain. A consensus document from the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine.

Promoting Pain Relief and Preventing Abuse of Pain Medications: A Critical Balancing Act, a Joint Statement. From 21 Health Organizations and the Drug Enforcement Administration, 2001. Available at:  http://www.deadiversion.usdoj.gov/pubs/advisories/painrelief.pdf  Accessed December 1, 2016.

Fine, PG, Portenoy, RK: A Clinical Guide to Opioid Analgesia, New York: McGraw Hill, 2007.

Reuben, D., Herr, K., Pacala, J., Pollock, B., Potter, J. & Semla, T. (2018). Geriatrics At Your Fingertips, 20th Ed. New York, NY: American Geriatrics Society (pp 247-268).