Natural Solutions to the Opioid Crisis
The opioid epidemic is raging out of control in the United States and other Western countries. Meanwhile, the discussion of natural alternatives is almost non-existent. As if nature doesn’t provide any pain relief.
The reality is that many pharmaceutical pain drugs have been developed as synthetic analogues of natural herbs that reduce pain. Aspirin, for example, was synthesized as an analogue of a constituent in Meadowsweet herb and Willow Bark.
Since then, pharmaceutical medical researchers have synthesized analogues for a large array of natural substances to provide patentable pain relief. One of the most famous of these is oxycodone.
The dark history of Oxycodone
Oxycodone is an opiate chemical synthesized from the opioid chemical paramorphine. OxyContin is a form of oxycodone – oxycodone hydrochloride.
Some call oxycodone “semi-synthesized.” But such a term is meaningless, because it is a synthetic compound that is toxic to the body in multiple ways. It is also highly addictive.
Oxycodone was synthesized in 1916 in Germany in an attempt to improve upon extracted opioids such as morphine and heroin.
Both morphine and heroin are extracted from the opium poppy plant. Morphine was isolated from opium in 1805 by a German pharmacist. Then in 1898, the Bayer company introduced its newest pharmaceutical, 3,6-diacetylmorphine, under their trademarked brand name of Heroin. Heroin is up to three times more potent than morphine.
Oxycodone was first sold in the U.S. in 1939, after being marketed by Merck as a combination drug with scopolamine and ephedrine.
Oxycodone was also used in clinical settings in Europe. From medical notes we understand that Hitler received frequent injections of oxycodone. Yes, this mass murderer was also an addict of a pharmaceutical drug.
In 1995, Purdue Pharma received approval for OxyContin. It quickly became a wildly popular drug to help patients with severe pain.
It also quickly became a recreational drug, as black markets worked to get what was intended for severe pain into the hands of those who wanted to get high.
By 2016, OxyContin and other synthetic opioids such as Fentanyl were responsible for over 20,000 deaths in the U.S. according to the Centers for Disease Control.
The darker history of Fentanyl
Fentanyl was initially synthesized and marketed by Paul Janssen and his company, Janssen Pharmaceutica. Brand names for fentanyl now include Fentora, Matrifen, Lazanda, Istanyl, Abstral Actiq, Duragesic and others.
Fentanyl is incredibly powerful and highly addictive. It is also dangerous, and deadly. Estimates are that fentanyl and its analogues can be more than a thousand times stronger than morphine and heroin.
Fentanyl applications include patches, capsules, injections and sublinguals.
Fentanyl is prescribed as a controlled substance, but it is also considered an essential pain medication for severe pain by conventional doctors. But it also comes with dramatic side effects, such as breathing problems and low blood pressure. It is also highly addictive.
The latter has become the greatest problem of fentanyl. It is so powerful and addictive that tens of thousands of people throughout the U.S. are dying from addiction to fentanyl or heroin that is laced with fentanyl.
Yes, heroin suppliers are now lacing their heroin with fentanyl. This is producing a wild-fire effect throughout the country, as heroin addicts are increasingly dying from heroin laced with fentanyl purchased on the street.
In fact, a majority of the 20,000 deaths in 2016 to opioids died related to fentanyl and its analogues.
But isn’t opium natural?
Yes and no. Certainly, poppy species such as Papaver somniferum do contain opiates. And poppy seeds – commonly eaten in breads and other foods – also contain trace amounts of opiates. But poppy seeds will not get you high. And neither are they addictive.
It is only when the sap from the immature seed pods is concentrated and opiates such as morphine are extracted do we find that kind of overdose and addictive power.
Long before pharmaceutical grade heroin and morphine were distributed by drug companies, natural opium was utilized by herbalists as a therapeutic medication. This came in the form of a tincture called laudanum, utilized not only as an analgesic but also as a treatment for maladies such as colic, lung infections, anxiety and insomnia. And because it wasn’t extracted specifically for its morphine content, a variety of medicinal constituents were available in the tincture.
Laudanum tincture contains about 1% morphine.
As time went on, the distribution of the pharmaceutical grade opium extracts became widespread and the world was inundated with these highly addictive forms. Then of course, the more deadly synthetic pharma versions were launched.
Even still, opium’s addictive potential of early natural forms is greatly overshadowed by today’s purified and intensified forms of morphine, heroin and of course the modern synthetic opiates like oxycodone and fentanyl – which are about a hundred thousand times more addictive than laudanum.
What about natural alternatives to opioids?
Many addictions to opioids occur as a result of an initial prescription to oxycontin or fentanyl. Often for pain that is transitory in nature. This means that many addictions could be circumvented if natural alternatives were initially used to reduce pain. Or at least natural alternatives were used along with non-opioid pain-relief drugs such as NSAIDs.
There are generally two approaches to pain relief when we discuss natural alternatives for pain.
The first approach is to understand the cause of the pain and utilize therapies that help the body heal the cause of the pain. This can take place with the use of herbs, acupuncture, massage and others.
To balance this approach, there are meditative exercises and mindfulness that help the mind manage the pain response. These approaches have been shown to also reduce pain and help the speed the body’s healing.
After all, the holistic approach to pain is to understand that pain is a signal from the body that something is wrong. So the goal should be to listen to the body and get to that source of the pain and help the body heal itself as quickly as possible.
Let’s discuss each approach separately, beginning with the latter.
Mindfulness and meditative approaches to pain
Several studies have shown that mindfulness meditation and the practice of meditative exercises such as yoga can help reduce pain and reduce the use of pain drugs.
A number of studies have investigated whether mindfulness meditation can reduce pain. For example, a 2016 study from the Wake Forest University School of Medicine worked with 95 people to test pain reduction therapies. They were given either the pain drug naloxone or mindfulness meditation at different times to test the same pain stimuli.
The researchers found that mindfulness meditation can significantly reduce pain. The researchers stated:
“Mindfulness meditation activates multiple brain regions that contain a high expression of opioid receptors.”
They also concluded from their research of other studies that mindfulness meditation can reduce opioid use during pain management.
Wake Forest medical school scientists also reviewed the research for the use of mindfulness meditation for fibromyalgia. They also found this form of meditation can reduce pain and reduce the need for pain medication. They wrote:
“Mindfulness meditation may provide an effective complementary treatment approach for fibromyalgia patients, especially when combined with other reliable techniques (exercise; cognitive behavioral therapy).”
Many other studies support these findings.
Yoga for pain reduction
A number of studies have concluded that yoga can significantly help patients manage pain. Many have also concluded a reduction of pain as a result of hatha yoga therapy.
For example, a 2016 study from the San Diego School of Medicine studied 150 veterans with chronic low back pain. Over a third of them were disabled or unable to work. They were given yoga classes twice a week for three months or the promise of future yoga treatment.
After three months, those who underwent the yoga classes had significant reductions in pain. These lower pain levels continued. After six months, the yoga participants had 2.48-point lower pain scores compared to the non-yoga group.
Other studies have shown that hatha yoga reduces pain and increases mobility.
Massage for pain relief
Massage offers a great facility for reducing pain. This, of course, depends upon the type and region of pain. But even massage that is focused on the body as a whole as the effect of reducing pain and refocusing the body’s neural network.
For example, a 2017 study from Indiana University and Purdue University followed 76 patients with chronic pain for six months. They were directed to a massage therapist for 10 massage sessions over a three month period.
After six months, the researchers found that over half had a significant improvement, while 40 percent saw clinical improvements, including reductions in pain.
Clinical research has shown that massage can significantly reduce chronic low back pain.
Acupuncture and Cupping
A significant amount of research has proven that acupuncture can be used to reduce severe and ongoing pain. Acupuncture has been used before, after and even during surgery to reduce surgical pain. One study found that acupuncture beat pharmaceutical pain medicine for reducing pain associated with sciatica.
Cupping is another healing therapy utilized by acupuncturists. Other research shows that cupping significantly reduces associated with fibromyalgia, as well as neck and shoulder pain.
Flotation therapy consists of floating in a tank of saline water designed to allow the body to lay on the surface of the water. Research has shown that floatation therapy can significantly reduce pain. Flotation can also reduce anxiety, depression and insomnia according to the research.
Herbs that help manage pain
Research has shown that a number of herbs safely reduce pain. This is not always about dulling sensation. In many cases, herbal medicines stimulate the body’s own healing mechanisms, allowing the body to more quickly heal the cause of the pain.
Most herbal medicines used for pain also reduce inflammation. Because the body’s processes for inflammation also stimulate the sensations of pain, reducing inflammation also can significantly reduce pain.
Herbal medicines used for pain can in many cases inhibit pain enzymes such as cyclooxygenase (COX) and lipoxygenase (LOX).
Still other herbs will stimulate the production of the Gamma-aminobutyric acid (GABA) neurotransmitters within the nerves or simply bind with GABA receptors. These all have the effects of reducing pain sensation.
Still other herbal medicines will reduce Substance P – which is part of the inflammatory pain cycle.
Let’s discuss a few of these natural pain-reducing herbs:
Willow Bark (Salix alba)
Willow bark contains, among other compounds, natural salicylins. As mentioned briefly above, the isolation of salicin from Meadowsweet and Willow eventually lead to the development of aspirin.
Willow has been used for thousands of years to help relieve different types of pain. Clinical research has shown that natural salicylin derived from willow inhibit both cyclooxygenase enzymes, COX-1 and COX-2. However, other flavonoids in willow have also been shown to inhibit COX enzymes as well.
Randomized human clinical studies on willow bark have shown pain-relieving effects that were similar to pain pharmaceuticals such as rofecoxib. Other studies have shown willow reduces inflammation and pain similar to celecoxib. Willow’s analgesic effects have been confirmed by a number of clinical studies over the years – without the side effects experienced from aspirin. A 2011 study that compared Willow to aspirin concluded the following:
“Flavonoids and polyphenols contribute to the potent willow bark analgesic and anti-inflammatory effect. The multi-component active principle of willow bark provides a broader mechanism of action than aspirin and is devoid of serious adverse events. In contrast to synthetic aspirin, willow bark does not damage the gastrointestinal mucosa.”
Meadowsweet (Spiraea ulmaria)
Meadowsweet contains many of the same salicins that are in Willow bark. For this reason, Meadowsweet extracts were used as analgesics in comparable settings with Willow prior to pharmaceutical companies’ analogue salicin products. And Meadowsweet provided the basis for the 1830 analogue that led to the Bayer company’s launch of Aspirin.
A 2016 review of research showed that Derris scandens treats muscle and joint pain similar to drug treatment.
Ginger (Zingiber officinalis)
Ginger contains many of pain-reducing constituents. Research has shown that Ginger matches or exceeds NSAIDs for reducing arthritic pain and menstruation pain. Other research has shown Ginger reduces joint and muscle pain and headaches. Ginger also reduces inflammation and inhibits both the COX-1 and COX-2 enzymes.
Research has shown that oils of Lavender, Clary Sage, and Rose help reduce pain.
Desert spike (Eremostachys laciniata)
This traditional herb is also called Chelledaghi in the Middle East. A 2013 study showed the herb successfully reduced pain while it also reduced infections after surgery in a study of 90 women.
Thyme (Thymus vulgaris)
Studies have shown that Thyme oil helps relieve pain associated with menstruation, even better than Ibuprofen.
Grapple Plant (Harpagophytum procumbens)
The roots of this herb – also called Devil’s Claw – have been investigated by German doctors for decades. The bulbs of the Grapple plant have been shown to relieve pain associated with headaches, backaches, menstruation pain and joint pain. Clinical research has shown the plant reduces inflammation as well as pain.
Myrrh (Commiphora mukul)
This ancient pain herb is also called Guggulu in Ayurvedic medicine. Myrrh was famously used by the Egyptians and the Greeks three to five thousand years ago, for a variety of inflammatory and pain conditions. These include joint pain and inflammation associated with mucosal membranes.
Goldenrod (Solidago virgaurea)
Goldenrod is a member of the daisy family and grows throughout North America. It was used by North American Natives for toothaches, sore throats and nerve pain in other parts of the body. It is also anti-inflammatory and antispasmodic.
Nettles (Uritca urens)
Nettles are found throughout Europe and North America and they have been used to help relieve inflammation and joint pain. It has been an ancient cure for arthritic pain and rheumatism.
Frankincense (Boswellia serratta)
In Ayurveda, this herb is called Boswellia. It is an ancient herbal remedy, used for various types of aches and pains. These included nerve pain and joint pain.
Cayenne (Capiscium frutescens)
Cayenne has been used for centuries to reduce pain. Clinically, it has been shown to inhibits the production of Substance P within nerves – which reduces the transmission of pain.
Turmeric (Curcuma longa)
Turmeric has been used medicinally for thousands of years, to reduce inflammation and pain. It reduces both LOX and COX type enzymes. It also reduces infection and speeds up wound-healing. Clinical research has shown Turmeric reduces arthritis pain and menstrual pain.
In Traditional Chinese Medicine, this herb is referred to as Lei gone teng. The Tripterygium herb has anti-inflammatory effects as well as pain-relieving effects. It has been shown in clinical studies to reduce joint pain and pain associated with rheumatoid arthritis.
Feverfew (Tanacetum parthenium)
Herbalists have used Feverfew for headaches and other types of pain for centuries. Research from Louisiana State University and the UK’s University of Reading confirmed COX-2 inhibition from its constituents parthenolide and melatonin.
Bakial Scullcap (Scutellaria baicalensis)
Research has confirmed that Bakail skullcap significantly reduces inflammation and pain related to inflammatory conditions. Researchers have confirmed the herb inhibits the COX-2 enzyme.
Hops (Humulus lupulus)
University medical school researchers have confirmed that the constituent from Hops – humulone – significantly inhibits the COX-2 enzyme. Whole herb Hops also helps relieve nerve pain and anxiety-related conditions.
Ashwagandha (Withania somnifera)
Ashwagandha has been shown to reduce inflammation and anxiety related to nerve pain. Ashwagandha has also been shown to bind with GABA receptors.
California poppy (Eschscholzia californica)
This herb is unrelated to the opium poppies. It is a completely different species of plant. It does, however have an analgesic effect and a relaxing effect. For this reason it has been defined as a nervine and pain reducer. Research has found it binds with the benzodiazepine receptor and GABA receptors.
Kava (Piper methysticum)
Kava has been used for thousands of years by Pacific Islanders for headaches and muscle pain. It has a sedative effect and provides muscle relaxation. Research has shown it binds with GABA receptors. Kava’s supposedly negative effects on the liver have been refuted.
The intelligent approach to pain
Not all pain is the same. And different types of pain will have different causes. On top of the cause of the pain will be our spiritual and mental approach to the pain.
Each of these elements provide the basis for natural medicine’s approach to pain. Herbs and natural therapies such as acupuncture, massage and others are aimed at assisting the body to remove the cause of the pain.
In the case of many of the herbs mentioned above, most of these contain a huge array of constituents that influence the body’s metabolism in a myriad of ways. Some of these herbs will encourage the healing process of organ and muscle cells. At the same time, they will reduce inflammatory signals and reduce pain sensations.
Some of these herbs will also add sedative effects and stimulate dopamine and other neurotransmitters that balance and reduce the effects of pain.
Meanwhile, most pharmaceuticals will contain one primary constituent. Whole herbs contain a more intelligent approach because their constituents will balance each other to minimize side effects.
Then we can add to natural medicine’s toolkit those activities such as meditation, yoga, tai chi and other forms of meditative exercise. These do double duty by encouraging the body to relax and learn to tolerate and co-exist with pain. They also encourage the person within (the spiritual person) to consider our spiritual journey, and the purpose of experiencing pain.
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Case Adams is a California Naturopath and a Board Certified Alternative Medicine Practitioner with a PhD in Natural Health Sciences. He has authored 26 books on natural healing strategies. “My journey into writing about alternative medicine began about 9:30 one evening after I finished with a patient at the clinic I practiced at over a decade ago. I had just spent the last two hours explaining how diet, sleep and other lifestyle choices create health problems and how changes in these, along with certain herbal medicines and other natural strategies can radically yet safely turn our health around. As I drove home that night, I realized this knowledge should be available to more people. So I began writing about health with a mission to reach those who desperately need this information. The strategies in my books and articles are backed by scientific evidence along with wisdom handed down through traditional medicines for thousands of years.”