Opioids are a huge problem in the U.S., affecting all walks of life. According to the CDC, almost 70% of drug overdoses leading to death are from opioids. For astronauts, experiencing pain or other health conditions isn’t all that uncommon. For example, astronaut Chris Hadfield, perhaps Canada’s most famous astronaut, complained of back pain and the feeling of someone “sitting on his chest” when he last returned from space. Hadfield was placed on a very specific exercise regimen, working directly with a doctor to stay safe.
But not all astronauts have the same resources. In space, bones, muscles, and joints can weaken if they’re not regularly used. At zero gravity, it can be hard to exercise the way you might here on earth. So when astronauts return, it’s considered normal to feel pain as their bodies readjust.
Like anyone else, astronauts aren’t immune to pain or the effects of the common treatments associated with it, including opioids. They also aren’t immune to addiction. Even though astronauts tend to be well-versed in biology, cells, and even how the medicine might work within the body, the desire to get rid of physical pain often trumps everything else. But, there are risk factors that come with admitting to addiction as an astronaut. For example, Buzz Aldrin explained in his memoirs that he was essentially shunned by NASA when he talked about his struggles with alcoholism and depression following the Apollo 11 moon landing.
So what can be done to help astronauts who are in pain and need help, but may be worried about how it would impact their career? Is it possible to safely take opioids, or should they stick to other treatment solutions?
The Importance of Ethical Prescribing
One of the biggest issues with opioid addiction is that medications aren’t being prescribed properly. In 2017, the average length of an opioid prescription was 18 days. There was a 21% chance for a patient to continue to use opioids after those 18 days, meaning their physician or nurse prescribed more. Yet cutting off the supply of opioids to medical providers isn’t the solution, the solution is ethical prescribing.
In NASA’s archives of the Apollo missions, they have listed what was in the medical kit for the astronauts. While these kits were obviously necessary, the drugs that were included in them are interesting, to say the least. Each kit, for example, had three injections of Demerol. This is an opioid pain medication that should be administered by a doctor. It’s very easy to overdose on Demerol, and even if you use it correctly, you can form an addiction to the painkiller. There was no accountability for how the drugs in these kits were administered and no “ethical prescribing” in place aboard a spacecraft.
Thankfully, the process is a bit different on earth. In 22 states, plus the District of Columbia, Advance Practice Registered Nurses (APRNs) have the authority to write prescriptions. The World Health Organization has put together guidelines for APRNs (and physicians) to follow when it comes to signing off on prescriptions. These extra steps can help to prevent unethical prescribing and make it harder for a patient to keep receiving opioids after a certain amount of time. The steps include:
- Evaluating the problem the patient is facing
- Determine the objective of drug therapy
- Choose the appropriate medication for the problem
- Educate patient with information, warnings, and proper instructions
- Monitor the patient
- Use appropriate prescribing software and other tools
Prescriptions should only be given out on an individual basis after learning of a patient’s specific needs. If those in the medical field want to help to reduce opioid addiction, ethical prescribing is a necessity. If an astronaut is in pain before they go up into space, they need to be prescribed the right medication and the right dosage ahead of time, rather than using painkillers ‘as needed’ from a standard medical kit.
Taking Opioids Safely
If you’re given prescription pain medication as an astronaut, it’s incredibly important to understand how to use it safely. The best thing to do is to listen to your nurse or physician when they inform you about the proper dosage as well as the risks.
Additionally, you can practice safer ways to take opioids by avoiding some common pitfalls people fall into. Avoid the following when you’re taking a prescription painkiller:
- Mixing with alcohol
- Mixing with illicit drugs
- Mixing with other prescriptions
- Using opioids to self-medicate
- Using opioids for stress
The schedule and dosage provided by your doctor should be the only thing you follow when it comes to prescription drug use. If you have other questions, don’t hesitate to contact your physician for information. They would much rather hear from you about your concerns than allow you to become addicted to a certain type of pain medication.
Natural Solutions for Pain Management
Some astronauts may want to avoid taking opioids altogether to completely eliminate the risk of becoming addicted. As a whole, more people across the world are showing a greater interest in natural health and wellness solutions.
Thankfully, there are plenty of ways to manage your pain without having to take prescription drugs. Even the future of individualized medicine is changing and may start to focus more on the use of peptides. Peptides are nothing more than fragments of full proteins. But, they can help to signal molecules in your body and encourage healing and pain relief.
If you’re trying to relieve pain on your own, natural ingredients are becoming more popular, including:
- Willow bark
Regular exercise, yoga, and even meditation can help with the effects of chronic pain or pain from an injury.
It’s incredibly important for astronauts to steer clear of drug abuse of any kind. But opioids don’t discriminate, and anyone can become addicted easily, even if you know the risks of the drug(s) you’re taking.
Addiction is more of a problem for astronauts than most want to admit. Thankfully, some are starting to talk about the struggles, including Canadian astronaut David Saint-Jacques, who is trying to educate the public on the mental and physical health risks that go along with being in space, including feelings of isolation and loneliness, and even an effect on the brain’s gray matter. Whether it’s pain from returning to earth after a long time in space, the fear of isolation causing you to reach for something, or an injury suffered years ago in training that keeps flaring up, it’s important to talk to your doctor about other options and possibilities so you can stay away from prescription painkillers as much as possible when you’re in this industry.