I wish we could develop pain medicines which are just as effective as narcotics but which do not have the abuse potential.
A few months ago, I injured my upper back at work. I had never injured that segment of my back before. I felt like there was literally a knife sticking into my back. Every time I took a deep breath, excruciating, sharp pain would course through me. I began to breathe shallow breaths to compensate, and this would bring on anxiety after awhile. It was the worst back pain I’ve ever experienced, and I have a lot of experience with back and neck pain. I went to some message boards to see if others had experienced this pain and what kind of treatments had worked. I found out that many people with thoracic spinal injuries cannot be helped. Surgery is rare and usually ineffective. Many of the people posting on these boards were so bereft of hope that they spoke about feeling suicidal. Many of them would have already ended things if not for family members they would hurt by doing so. I finally had to get off the boards because it was so disturbing. Thankfully, my injury began to heal and in about a week, I felt completely back to normal.
I understand how people can become so dependent on these painkillers when faced with excruciating, relentless pain. They become enmeshed in a spiral, desperately seeking relief, becoming more and more tolerant of the doses of meds that did work before, and being treated like worthless “addicts” when they interface with hospitals and medical professionals who have become so jaded that everyone who seeks pain relief is seen as an addict just looking for a high. As a nurse, I’ve witnessed the attitudes many nurses and doctors carry about almost anyone who asks for narcotic pain medicine. It’s not necessarily hard to understand, as there are addicts who come into the system who really are not in pain, but are simply addicted to the meds. These patients can be very frustrating, and often demand time that nurses simply don’t have, given the high nurse to patient ratios we are seeing in hospitals now. But the chronically ill patients who desperately need these drugs are painted with the same brush, and it’s a nightmare for them.
Pain management has become its own specialty, and it’s improving, but we clearly are not where we need to be. It’s a very sad situation.
@nrdsn4:
There are things like that, on CBS News Radio in NYC they interviewed a local plastic surgeon and he uses something that is put in intraveneously during surgery that will last for significant period of time after the surgery and is not addictive, and others are actively using and searching for alternatives to the addiction causing drugs. They also talked to several experts in pain management at NY Presbytyrian hospital, and they said part of the problem is that the companies making the opiods had such a huge marketing effort presenting these drugs as safe and effective, miracle drugs to take away pain (to quote one of the doctors), that little effort was made to find alternatives because many doctors believed these were safe at the dosage levels the companies were saying (from what I understand this may turn into the equivalent of the Tobacco suits, more and more states are suing the drug manufacturers claiming they knowingly marketed products that were harmful at the dosage levels they indicated and that they also used their influence with doctors and practioners to have these routinely prescribed), and apparently if the report is correct these kinds of drugs are some of the most profitable for the companies making them. I can’t gauge the veracity of the lawsuits or the claims, given you can sue over anything, but it will be interesting to see if the claims are proven in court the way it was with tobacco.
Pain relief still has a long way to go. I never wanted to go down the path of narcotics for my chronic issues. But the choices remaining have some big drawbacks. NSAIDS help a lot but can cause serious problems if taken long term. I’ve had a neck flare up, and I’m taking the highest doses of NSAIDS I’m allowed to try to get it under control. But I have to really be careful-I’m taking prilosec to try to avoid ulcers, there are risks for bleeding, some NSAIDS carry a risk of heart attack. I can try a steroid injection, but that doesn’t always work, it’s expensive, invasive, and usually requires a series of appointments and diagnostics. Sometimes, by the time I get all those done, I’ve actually calmed down. Later flare ups usually require repeat diagnostics if a certain amount of time has gone by. Physical therapy helps SOMETIMES, but not always, and is expensive and time consuming. I used to use Bextra, and for me, it was a miracle drug-but then it got taken off the market.
My neck was hurting so bad the other night that I woke up at 1 am and just could never get back to sleep. My flare ups usually resolve in a matter of weeks (until the next one), but I get incredibly frustrated by them, and I can totally see how people who remain in pain on a constant basis can get depressed and feel completely hopeless.
I had surgery a few months back, and needed opioids for just a few days (specifically just until I was allowed to take aspirin again after surgery). I hope that in all of the hysteria about over-use of opioids we don’t forget how important they are for short term use for people who really need them.
“I wish we could develop pain medicines which are just as effective as narcotics but which do not have the abuse potential.”
It seems to me that a place to look for such medicines might be derivatives of marijuana. I have long wondered why derivatives of opium are legal, but derivatives of marijuana are not at the federal level. Clearly this is NOT because opium is so much safer.
@DadTwoGirls, I’ve never used marijuana, so I can’t speak to the pain relief properties. I know many people have been helped by it. For me, it would need to become legal on a federal level. I am a nurse and subject to random drug screens. I would lose my license if I ever tested positive for THC, even if using it legally. Most Boards of Nursing forbid use of marijuana products, even in states where it’s legal as a recreational drug.
If I ever decide to hang up my stethoscope for good, I will certainly be looking into it.
We used to dispense THC in capsule form in the hospital WAY back when (late 70’s maybe early 80’s) in the hospital for cancer pain.
Then it became classed as schedule I (no medical use) from schedule II ( narcotic status) and no longer able to be dispensed. I honestly don’t remember the potency of what was available. No idea if it helped anybody (I do know not everyone was happy when the option disappeared). It was just another pain med that was tried.
I was around when Valium was introduced as the “non-addictive” drug for anxiety. Major marketing in that regard.
Bunches of those types of drugs with “non-addictive” claims have come and gone. Seems just about everything can be abused by somebody in some way.
My main concern after all these years (20-20 hindsight) is that the banning of certain drugs has led to lack of research into use of these drugs. The federal ban over all these years has led to drug dealers being the “experts” in the field rather than legitimate researchers (who still can’t do anything with federal bans even with state blessings.)
My husband needs regular, strong meds for pain due to benign tumors on his spinal cord . Opioids aren’t a choice because of their digestive system effect. He’s on Gabapentin, which doesn’t seem to do much. Visited Oregon and tried CBD tincture… his evaluation was that it was about like taking 4 tylonel. Of course everything is unregulated and unmetered.
“My main concern after all these years (20-20 hindsight) is that the banning of certain drugs has led to lack of research into use of these drugs.”
Apparently many years ago there was some sort of federal US rules or laws that specified the composition of silver/mercury dental fillings. Because of this the research into better fillings occurred in Canada (I was told in Toronto), rather than in the US. Eventually the US allowed the improved filling materials to be used here.
Probably the same thing will happen wrt marijuana derivatives for pain control. The research will need to be done in other countries. When very good results are found elsewhere, we can hope that the US will eventually catch up.
“Probably the same thing will happen wrt marijuana derivatives for pain control. The research will need to be done in other countries. When very good results are found elsewhere, we can hope that the US will eventually catch up.”
Which is just stupid beyond belief…hiding your head in the sand never helped anybody.
To give you an idea of the scope of the problem, the other day they busted a ring operating out of a medical office in NYC, it was 7 people (some doctors, some nurses it said) who were responsible for something like 6 million tablets of prescription opiods getting into the black market in NYC…and that was supposedly over the course of only a couple of years. One of the things that I think it is high time is that all prescriptions should be written electronically (my local MD has been doing that for years) to allow the data to be tracked, paper prescriptions can lead to situations like the above because there isn’t an easy way to monitor it, this would help cut out at least some of the black market activity by shady doctors and the like, and also could lead to real statistics on just how much opiods (or anything) were being used, would also be good for hard data on things like overusing antibiotics, if it is still a problem.
NBC ran a segment today about opioid addiction. A doctor observed that for patients prescribed ten-day supplies of opioids, one in five will become addicted to them! What about my 30-day supply of an opioid the doctor handed me when I left the hospital …30% chance…40% chance? I don’t like those numbers.
Shouldn’t there be huge warnings on bottles of opioids? And every patient needs to be counseled on the dangers of these drugs before popping a pill down their mouth that could change their life. I was told nothing. I had so much paperwork and was on so much medication that the opioids weren’t given a second thought.
That number sounds like it was pulled from the air. Like to see a study.
From Web MD
A 2008 study that compiled previous research found that about 3% of people with chronic non-cancer pain using opioid drugs abused them or became addicted. The risk was less than 1% in people who had never abused drugs or been addicted.
The study followed the opioid use of 1,300,000 patients between 2006 and 2015. It was recently published by the Centers For Disease Control. Here are some figures:
