Opioids Not a Great Answer to Chronic Migraine

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July 25, 2014

Wouldn’t you find it disappointing to learn that a common emergency room protocol for managing migraine symptoms has not improved in over ten years? Fortunately other treatments like Botox injections and the Omega™ migraine procedure have emerged as drug free alternatives for the disabling pain, nausea and sensory symptoms associated with chronic migraines.

Migraine medication, when tolerated by the patient, is very effective when used as prescribed for episodic migraines. While often used for chronic migraine, long-term usage may give rise to unpleasant side effects.

Researchers presented the findings of a recent study, at the annual American Pain Society meeting, which revealed emergency room physicians have continued prescribing opioids to approximately 50 percent of patients with migraine symptoms despite the suboptimal outcomes.

The study indicated that, during the period between 1998 and 2010, this protocol continued despite newer recommendations in favor of prescribing alternative medications. The results also indicated that among migraine patients receiving opioids, the average emergency room stay was 178 minutes compared with 90-minute stays by those receiving triptans. According to the article, doctors prefer to monitor patients receiving opioids longer to make sure they don’t experience life threatening drug reactions.

Opioids are a class of controlled pain drugs that interfere with pain signals by binding to opioid receptors. According to Wikipedia they diminish the perception and reaction to pain as well as raise pain tolerance. Opioids are prescribed for chronic pain associated with cancer, but are not well suited for chronic migraine pain.

Side effects include drowsiness, nausea, hormone imbalance, constipation, and addiction. When the usual medication prescribed for migraines doesn’t work, and isn’t tolerated by certain individuals, opioids and anti-emetics (anti-nausea medication) might be the next step in managing symptoms. Perhaps a better drug free solution for managing chronic migraine should be the Omega migraine procedure?

In a MedPage Today interview, the study’s lead presenter said, “we are well into the triptan era, and those drugs as well as ketorolac and the anti-emetics are all really superior to opioids. They are better than opioids in reducing pain and allowing people to get back to work quicker. There is also concern that opioids might by harming the patients by making the underlying disorder worse. By giving them opioids you are inviting these patients back for more.”

Choosing to undergo a migraine procedure could be a great next step in managing your chronic migraine pain without relying on emergency room visits and powerfully addictive opioids.

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