pain and medication management

Additional information about pain and medication management is available at your county FSA or Extension office.

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Last fall, during National Farm Health and Safety Week, an RFD Radio story focused on chronic pain, calling it “A New Threat to Farmer Health and Safety.”

Actually, health and safety researchers have recognized chronic pain among farmers as a problem for many decades. I’m sure this is not news to many of you who have first-hand experience with the physical work required in farming.

Although managing pain while farming isn’t necessarily new, strategies have definitely changed. The current concern about opioid over-prescription and misuse may cause many to worry about prescription pain medication and seek non-prescription relief.

Sometimes opioid pain medications are necessary, however, and in those cases, one should be aware of how to store and dispose of them safely.

Prescription opioid drugs are pain relievers that are either naturally derived from opium in poppy plants or produced chemically. They are highly addictive, producing a relaxed and euphoric sensation, as well as pain relief. Common prescription opioids include morphine, codeine, hydrocodone, oxycodone and oxymorphone.

These drugs are very effective at managing pain for short periods, but can lead to dependence and overdose if used for too long or outside of the guidelines of the prescription.

According to a recent report by David J. Peters and others at Iowa State University, opioid use-related deaths in rural areas are primarily from prescription drugs. The authors note that these areas have older, mostly white, non-Hispanic residents, higher poverty rates and jobs with high rates of injuries.

They write, “This suggests a link between opioid addiction and work-related injuries, coupled with economic decline.”

A survey conducted in 2018 by the American Farm Bureau Federation and the National Farmers Union found that farmers and agricultural workers are very familiar with opioid misuse. Seventy-four percent of respondents reported being directly affected by opioid misuse, either from knowing a friend or family member or having themselves misused opioids.

In addition, only about one-third reported that it would be easy to access treatment for prescription drug addiction in their area that would be effective and affordable.

For those working in physically demanding or injury-prone industries, including farming, managing pain — with or without medications — may be necessary. Any strategy should be worked out with your doctor.

In farming, knee, shoulder and back pain are all very common. In some cases, such as with shoulder pain, you may have an injury that could be improved with surgery. Back pain may be related to long hours on vibrating equipment combined with heavy lifting.

Your doctor can help identify the source of pain and develop a plan to manage it that will keep you as productive as possible.

There are several strategies that do not involve medication at all. These include physical or massage therapy, acupuncture, appropriate exercise and stretching and even cognitive behavioral therapy or “talk” therapy. In addition, over-the-counter medications, including Tylenol, Ibuprofen or topical treatments (Aspercreme or BenGay) can provide relief.

There are times where prescription opioid medications are necessary, in either the short or long-term. In these cases, it is important to work closely with your doctor and manage your prescriptions to reduce the risk of non-medical use or accidental ingestion by others, as well as environmental contamination during disposal.

All medications should be stored securely, in a cool, dry place, out of the reach of children. Although it’s called a “medicine cabinet,” the bathroom cupboard is not a good location for prescription medications. Instead, store them out of sight in a secure location. Take an inventory of your medications every six months and dispose of any that are expired or no longer used.

According to the Farm Bureau and Farmers Union survey, 77% of farmers and farm workers say that it is easy to obtain prescription opioids without having a prescription. Theft of prescription drugs is a significant problem that contributes to the supply of illegal opioids in many communities.

It is important to dispose of unused medications when they are no longer needed, but it is not safe to throw prescription drugs directly into the trash. Follow the instructions for disposal on the drug label or take unused medications to a local pharmacy, sheriff’s department or waste management service that has a drug take-back program.

An at-home drug disposal system is also an option. These consist of a pouch or container with activated charcoal that neutralizes drugs and makes them safe to dispose of in the household trash.

This spring, Iowa’s Center for Agricultural Safety and Health distributed handouts describing both non-opioid pain management strategies and best practices for storing and disposing of medication. These went to ISU Extension and Outreach and Farm Service Agency offices in every county, along with samples of drug disposal pouches. Stop into your local office to pick up these items, or contact I-CASH for more information.

Pain is one of the leading causes for primary care visits in the U.S. Fortunately, there are numerous options that can provide relief. Don’t hesitate to talk with your doctor about strategies that can help you farm without pain.

Brandi Janssen, PhD, directs Iowa’s Center for Agricultural Safety and Health at the University of Iowa.

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