Why are doctors ditching opioids and what are they prescribing instead?

More and more doctors in the US are avoiding prescribing opioids to their patients for pain relief, citing the crisis of addiction and resulting overdose-related deaths. The trend is being taken well by their peers but the patients, always looking for opioid-like euphoric relief, may not be happy with the switch.

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.

Opioids work by blocking your brain's sensation of pain. They can also affect the pleasure centre of your brain, causing a sense of euphoria. When taken as directed, opioids can be very effective in relieving pain.

According to some figures, more than 932,000 people died from the overdose, with yearly numbers increasing.

The Centres for Disease Control and Prevention noted that Opioids are involved in about eight out of 10 overdose deaths.

Despite all this, what doctors are suggesting then? The answer is muscle relaxers. It is because they cause lower dependency and are less risky to human health.

Jesse Bracamonte, a physician in the Mayo Clinic Health System in Phoenix, Arizona said: "Opioids are being scaled back considerably and muscle relaxers are often recommended as a safer alternative, so long as they are not abused and are used as prescribed."

However, there are concerns that they may not work well with some risks associated.

Muscle relaxants

Muscle relaxants or also known as muscle relaxers are used to treat muscle pain and spasms.

Trevor Rich, a physician in the Mayo Clinic Health System in Mondovi, Wisconsin noted: "Muscle relaxers belong to a rather wide range of medications with the design to provide patients with relief from muscle spasms or muscle spasticity."

Functions of muscle relaxants

Muscle relaxers are typically taken orally, "to relieve pain, spasm and stiffness of skeletal muscles by depressing the central nervous system," said Christopher Gharibo, director of pain management at NYU Langone Health.

"They work in different parts of the central nervous system by altering the neurotransmitters that are responsible for communicating impulses to the skeletal muscles," he noted.

"Some muscle relaxants can also be beneficial in certain headache conditions or even neurological pain," added Gharibo.

According to Rich, there have been "well-designed systematic reviews of these prescriptions" dating back more than two decades, and such research has "provided high-quality evidence illustrating these medications are more effective than placebo for short-term relief of muscle spasms, primarily low back pain."

However, Bracamonte underlined that the medications don't work for everyone, and some people report only limited relief.

"I often prescribe my patients muscle relaxers to use along with other treatment options, including surface remedies, to maximise their combined effectiveness," he underlined.

Side effects of muscle relaxants

Extreme drowsiness in some people is a known side effect of it.

For this reason, Rich said, physicians will often warn patients not to drive or operate machinery while on therapeutic dosing.

People also become habitual of it causing some people poor focus, dry mouth, liver enzyme elevation, low blood pressure, and interactions with other medications, according to physicians.

Adam Tenforde, director of running medicine for Mass General Brigham in Boston, noted: "Muscle relaxers should be used with caution."