Benefits versus risks of taking Opioids

I wish every Doctor and the DEA would read articles like the one below. I was reading a news story last night about a DEA agent that was injured while on a raid. Now he is on a morphine pump and he talked about the difficulty in trying to get a doctor to treat him. We are all at risk here folks. It can happen to anyone. That's why it is so necessary for there to be more education about opioids and why they will stop severe pain when nothing else will. There is really a lot of research going on in this area. I just hope it doesn't fall on deaf ears.

As controversy swirls about proper clinical use of opioids and other potent pain medications, research reported at the American Pain Society annual meeting shows that, contrary to widespread beliefs, less than 3 percent of patients with no history of drug abuse who are prescribed opioids for chronic pain will show signs of possible drug abuse or dependence. In his plenary session address, Srinivasa Raja, MD, professor of anesthesiology, Johns Hopkins University Medical School, urged clinicians and policy makers not to allow the small percentage of abused pain prescriptions to prevent legitimate pain patients from getting the care they need.

"Physicians today face a dilemma in trying to balance the needs of their patients with demands from society for better control of opioid medications. We also are dealing with unfounded accusations in the media that increased prescribing of opioids for severe chronic pain is responsible in large part for reported upswings in the abuse of pain medications," said Raja. "We do need stronger evidence about which patients will benefit most from these medications to help make better prescribing decisions," he added. "But for most chronic pain patients, drugs are not the sole solution. More and more studies are showing that multi-faceted treatment involving physical and cognitive-behavioral therapies and appropriate interventional strategies lead to the most favorable outcomes." According to Raja, the problem of prescription drug abuse can best be attacked and hopefully solved through collaborations involving care givers, regulatory and law enforcement agencies and the pharmaceutical industry.

"First, I believe physicians should be diligent is communicating with their patients about the benefits and risks of opioids and also screen them for drug-seeking behavior and other warning signs of potential abuse," said Raja. "Also, we must monitor patients carefully to determine when doses can be lowered over time as they improve their pain control and overall functioning." The message for law enforcement and federal and state regulatory agencies, first and foremost, is to strive for state-to-state consistency in regulating controlled substances and crack down on illegal internet pharmacies and prescription thefts and forgeries. "Progress is being made as there is increased awareness of the source of prescription opioids being diverted into the illicit market," said Raja, "and states and municipalities are stepping up their teen drug awareness education programs."

For pharmaceutical manufacturers, Raja said the key challenge is to match clinical needs for less addicting pain medication with drug development priorities. "There are novel analgesic formulations in various stages of development that we hope can be prioritized and expedited for clinical use," he said. Raja noted that fifty years ago, a commentary published in the Journal of the American Medical Association recommended that opioids should be avoided in treating cancer pain because of possible addiction, and 20 years ago it was believed infants didn't feel pain and shouldn't receive anesthesia. "We abandoned such faulty beliefs as scientific evidence proved otherwise," he said. "Now I hope history repeats itself in changing professional and public attitudes as we now know opioids are effective for treating chronic non-cancer pain and that very few legitimate pain patients abuse their medications.

Hopefully, the evidence will foster a middle-ground approach that protects the rights of patients and clinicians while upholding society's right to control medication abuse and diversion."

http://www.medicalnewstoday.com/articles/107028.php

The Chronic Pain patient and Opiods

It is not my intention to say that every person who walks into a Doctors office and complains of pain should be prescribed opiods. However the previous statement does not describe a chronic pain patient. These people are like me. They have had numerous operations and other invasive procedures that have not stopped their pain and in most cases has only made it worse. Most chronic pain patients hate taking pain pills. What they really want is a normal life. Below is part of an article from WebMd.

"In the last few years, everyone's heard about the apparent epidemic of prescription drug addiction, especially to narcotic painkillers. We see human-interest stories on the news about regular folks getting hooked on OxyContin or Vicodin. Every few months, it seems, we get another news release from a new celebrity confessing to an addiction. The reports may give you the impression that the lure of these drugs is irresistible, that we're all just a few pills away from addiction.

This leaves many people with chronic back pain -- and often their doctors -- stuck in the middle. On the one hand, they're afraid of the risks of addiction that come with powerful painkillers. On the other, they're suffering from severe and debilitating pain and need some kind of help.
But are the risks of prescription drug addiction really as great as we think?
"There's this buzz that these painkillers are demon drugs being marketed to unsuspecting grandmas," says Karen Miotto, MD, an addiction psychiatrist at the UCLA Neuropsychiatric Institute. "But that's not the case."

There's no doubt that prescription drug addiction can be devastating and destroy lives. But for many experts, the more widespread public health issue is that people in desperate and debilitating pain aren't getting the painkillers they need because of inflated fears of addiction. While opioid painkillers -- like OxyContin, Percocet, and Vicodin -- have risks, they're often outweighed by the benefits, experts say.

Source: By R. Morgan Griffin

And the above is true. I personally know several people in the level of pain that I am in. None of them are addicted to anything. They are just like me, all they want is the ability to have some kind of life.

Doctors have opiodphobia

Where do you turn when you walk out of a physicians office after he has just told you that he cannot prescribe anything for your pain because he is afraid you will become addicted? Your pain level is so high that you are wandering if you can make it through the day, yet this so-called medical professional is more worried about addiction than your pain. Something is terribly wrong with this picture. This is what the "chronic pain individual" faces every single day of their life. Opiodphobia!! that is what I call it. It doesn't matter if you have no record of any kind of addiction. It is just like being found guilty before having a trial. If you are a "chronic pain "sufferer you are stigmatized.

I recently changed primary care physicians and started calling around to find a new one. The very first one I called, as I was describing my problems to her and mentioned chronic pain, this was the exact reply. Well I will tell you right now, we don't prescribe "narcotics". This statement only shows the lack of education the medical industry really has on controlling chronic pain. First of all they are not narcotics. This is a law enforcement term. The medical name for these drugs are opiods, opiates or "Schedual II controlled substances approved by the FDA for treatment of severe chronic pain and cancer patients. You don't become addicted. Addiction is a behavorial problem in people, and some of it is even hereditary. People who take street drugs to get high and sometimes people who take drugs for pain and continue after they no longer need them. That is addiction. The correct term is "chemical dependency" which is a normal occurance in anyone who has to take this type of drug. To get off of them when you no longer have to have them, tell your Dr. and he will start slowly lowering your dosage until you are completely rid of them. How do I know all of this. Four back surgeries and multiple intravenous injections, all of which have only made my problems worse and 25 years of sitting up all night reading every piece of medical publication I could find on the internet, watching surgery webcasts, and listening to the surgeons who are not afraid to tell the truth. The person who lives in chronic pain lives the most lonely, painful life in the world.