Migraine Treatment Guidelines Shift Away From Opioids, Towards Nerve Blocks
CALGARY – New guidelines from the American Headache Society are considerably altering migraine treatment protocols, strongly discouraging the use of opioids and promoting nerve blocks as a viable option. The updated recommendations represent a firm departure from the 2016 guidelines, which only discouraged opioid use, and reflect a decade of evolving research.
Neurologist and University of Calgary researcher Serena Orr, who contributed too the guideline changes, explains the shift is driven by a growing body of evidence demonstrating safer and more effective treatment options. “There are many other options that research describes as better, more effective, safer than opioids.And we know there are plenty of other problems with opioids,” Orr stated.
A key component of the new approach involves occipital nerve blocks – injections of anesthetic into nerves at the back of the head. according to Orr, these injections can rapidly alleviate pain. ”We think that [this injection] reduces all pain signals throughout the head. The patient no longer feels any sensation within a few minutes.” She hopes the updated guidelines will lead to wider access to the treatment, stating, “But now, with more research and guidelines, we hope that it will be offered to all patients who are interested.”
The injections can be administered by emergency physicians,general practitioners,neurologists,and trained nurse practitioners. While the 2016 American Headache Society guidelines were adopted in Canada, Orr is advocating for the Canadian Headache Society to adopt the latest revisions.
Sandra Pick, an Edmonton resident who has lived with migraines for over 15 years, shares her experience with opioids. “You get used to it, and the medicine no longer works well,” she said.Pick found nerve block injections to be a more effective solution, reporting, “In about 30 minutes […] I really felt better.” However, she notes the relief is temporary, with effects lasting approximately 24 hours.
With the collaboration of Terri Trembath
