Pain is a vital sign that serves to indicate malfunctions and calls to take measures. Chronic pain differs in this aspect, as it does not complete a protective function. This syndrome is one of the most common health issues that pushes patients to visit their doctors – chronic pain can considerably reduce an individual’s life quality, rendering them habitually nervous and distressed. Currently, the mechanisms behind chronic pain seem not to be investigated exhaustively. Nonetheless, new, more efficient treatments and a considerable body of literature dedicated to the health issue emerge, encompassing an array of techniques to alleviate it. Therefore, chronic pain is one of the major public health challenges that necessitates further investigation – three scholarly articles and approaches to treating pain were selected for an overview, synthesis, and evaluation of their efficacy.
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The Use of Opioid Buprenorphine
As managing chronic pain can be associated with opioid pain relievers, ways to prevent this addiction are developed. Pergolizzi and Raffa (2019) consider opioid buprenorphine as an adequate option, an opioid used in the United States for chronic pain since the eighteens. Based on the performed study, the researchers indicate that buprenorphine does not lead to abuse of the substance or respiratory depression (Pergolizzi & Raffa, 2019).
They also accentuate that it can be used among patients of varying ages (Pergolizzi & Raffa, 2019). To achieve this conclusion, controlled clinical trial information was analyzed, and more than one hundred studies were overviewed. Among these studies, Pergolizzi and Raffa (2019) selected thirty-three, exploring transdermal buprenorphine or buprenorphine buccal film. Transdermal buprenorphine’s capacity to relieve pain effectively was demonstrated in several analyzed clinical trials, not depending on the type of chronic pain. The article also underlines higher patient compliance rates due to the ease of transdermal buprenorphine administration (Pergolizzi & Raffa, 2019). Given the number of analyzed clinical trial information and its source (EMBASE, Medline, and PubMed), the achieved conclusions seem to be well-established and credible.
The outlined in the overviewed article data suggests that the medication is one of the primary choices for managing chronic pain, especially if combined with opioid addiction. Furthermore, the need to create a comprehensive picture of potential side-effects and consider in-depth patient’s peculiarities before choosing opioid therapy are emphasized. In this way, the research is grounded in extensive clinical information – this serves as a primary indicator for the validity of the presented data. Being randomized, the study is based on a representative sample to suggest the advantages of opioid buprenorphine use. Its conclusions are supported by years of opioid buprenorphine’s presence on the market, patients’ experience, and a detailed data breakdown.
Cannabis and Cannabinoids for Chronic Pain Treatment
Over the last decades, the popularity of cannabinoids for managing chronic pain augmented gradually. Given the relative novelty of the substance’s usage in a clinical setting, a lacuna in medical knowledge was created. Romero-Sandoval et al. (2017) examined potential analgesic effects contributed to cannabis and cannabinoids as well as their long-term safety. To establish the overall efficacy of this medication, the researchers analyzed different types of cannabis administration and presented the advantages and disadvantages of each. The study’s findings suggest the superior efficiency of inhaled cannabis for alleviating chronic non-cancer pain due to its tolerability and predictability. In this respect, the researchers state that its “pharmacokinetics allow for self-titration (which maximizes analgesic effects), reduces side effects or dysphoria, and drug exposure when pain is controlled” (Romero-Sandoval et al., 2017, p. 2). On the other hand, oral administration is showed to be less effective and entail more limitations.
The study presented in the article seems to be principally based on research data conducted by other scholars and already-available clinical information. The article does not provide a thorough description of methods or samples used in separate sections, incorporating related information over its course to explain findings and conclusions. Describing procedures, a research sample, and questions separately would possibly render the source’s structure more defined and easier to navigate. On the other hand, the article could serve as a directive to the use of cannabis and cannabinoids for chronic pain treatment. This assumption is based on the exhaustiveness of its material and analysis of several routes of administration and types of pain; it also mentions limitations associated with each route. Thus, the study allows generalizations apropos of the use of inhaled cannabis for chronic pain, providing sufficient support for its efficacy.
Non-pharmacological Chronic Pain Treatment
As the nature of chronic pain is not fully discovered, non-pharmacological chronic pain management such as acupuncture, virtual walks, or physical exercises also contribute to mitigating this health problem. In response to the threat of opioid addiction that some treatments entail, Majeed et al. (2018) claim that mindfulness-based approach could be an alternative to pharmacological chronic pain management. The notion includes activities aimed to increase mindfulness such as meditation, yoga, and exercises for decreasing stress. The researchers conducted “a selected systematic review using filters for randomized control trials, randomized clinical trials, and meta-analysis published within the past five years on Medline/PubMed, Web of Science, Google Scholar, Psych INFO and Cochrane Database of Systematic Reviews” (Majeed et al., 2018, p. 89). The outcomes of mindfulness-based stress reduction (MBSR) were compared to cognitive-behavior therapy (CBT) – patients undergoing MBSR for twenty-six weeks reported lower disturbances on a graded chronic pain scale (Majeed et al., 2018). This improvement serves as considerable evidence for the therapy’s success. Moreover, the number of participants (three hundred forty-two) allows making generalizations about its results.
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Nevertheless, MBSR potentially functions the most efficiently in a complex with other pain management methods. According to Majeed et al. (2018) “when MBSR is integrated in a comprehensive pain management plan, consumption of pain-related medications is reduced, pain interference with daily life activities decreases and self-esteem, body image and activity levels improve” (p. 96). This conclusion indicates that the overviewed study additionally reflects on the extent to which the treatment is effective in various combinations, enhancing its completeness. The study uses extensive data and relevant to its research questions methodology; it clearly outlines the ways MBSR can be applied and demonstrates an understanding of its disadvantages.
In this paper, two pharmacological and one non-pharmacological approaches to chronic pain treatment were overviewed and analyzed. The articles were selected based on their applicability to the topic, publishing journals’ credibility, and relevance. Non-pharmacological chronic pain treatment and management seem to gain increasing approval due to the absence of addition risk, substance abuse, and improved treatment outcomes; such methods do not result in anxiety and depression. Additionally, the risk of developing addiction resulted in incorporation of opioid buprenorphine into the chronic pain treatment. On the other hand, implementation of cannabis and cannabioids also grows, which allows researchers determine most efficient administration routes and the methods’ disadvantages.
Majeed, M. H., Ali, A. A., & Sudak, D. M. (2018). Mindfulness-based interventions for chronic pain: Evidence and applications. Asian Journal of Psychiatry, 32, 79–83.
Pergolizzi Jr, J. V., & Raffa, R. B. (2019). Safety and efficacy of the unique opioid buprenorphine for the treatment of chronic pain. Journal of Pain Research, 12, 3299–3317.
Romero-Sandoval, E. A., Kolano, A. L., & Alvarado-Vázquez, P. A. (2017). Cannabis and cannabinoids for chronic pain. Current Rheumatology Reports, 19(11), 1-10.