Posted on 06/05/2013 6:43:02 AM PDT by DBCJR
Prescribers and the public have been misinformed about the risk of addiction when chronic pain is treated with opioids. This has led to overprescribing of opioids and the worst drug epidemic in U.S. history.
Even when taken as directed, patients receiving long-term opioid therapy for chronic pain can become addicted.Physicians who find their patients addicted, i.e., experiencing higher and higher tolerance requiring higher and higher dosing, should consider a referral to a SAMHSA evidence-based best practice Medication Assisted Treatment program at a SAMHSA CSAT certified Opioid Treatment Program.
In Oklahoma call 877-341-3017
We are all just a car accident or some major surgery away from becoming Rush Limbaugh.
My one significant experience with opioids — six weeks in connection with a pituitary tumor and its removal by surgery — convinced me of how easy it is to become habituated. Even though relatively brief and medically justified by pain, at the end of six weeks, I went through several days of flu-like withdrawal symptoms.
Bear in mind that SAMSHA is a government agency who’s funding is dependent on them finding a problem that needs to be solved.
In Europe, doctors are prescribing opioids - which don’t work in a lot of cases - like they used to prescribe Valium in the sixties, that is, for anything and everything. At the same thing Europe has placed a chokehold on simple aspirion, which is cheap AND works, while placing a price premium on it - 24 pills for $6-7 and limited to 1 24-box a day.
About 5 years ago I had my gallbladder taken out. However about 2 years later I began having gallbladder attack symptoms. The pain was identical to my earlier attacks and I began visiting the ER for pain relief. A doctor at UVA looked at me and felt there was a stone left in the stub of the duct left and scheduled me for surgery. In the meantime, I had 3 - 5 attacks a week. It got to the point my husband would take me to the ER and say “You’re gonna want to push 10 MG of Dilaudid with some Zofran and then a 5 MG chaser of Dilaudid in about an hour. Here’s her DR’s card to call for verification she’s not a drug seeker.” Done.
Had the stone taken out and the attacks stopped.
Then I discovered I had developed a bit of addiction to the pain killer and had to detox. Skin crawling, shaking, itching, horrible, horrible.
To this day I still react funny to any pain med other than a mild OTC and just refuse to take anything with an opiate base. Not doing the detoxing again....ever
Yes, they are very addictive and I have seen numerous people struggle after a brief time on them.
Oxycontin is both a miracle drug and the Devil’s drug rolled into the same pill. If you REALLY need it, it works. But it WILL addict you! In as little as a week! I had horrible pain from adult croup a few years ago, and in the hospital, amongst large doses of IV steroids and other drugs, I was given frequent, fairly large doses of IM morphine to control the pain.
There was no desire to continue the morphine at all when I left the hospital, but I was given Oxycontin to take home with me for the residual pain. After 4 days of taking it, I found myself “needing” to take it even though the pain had pretty much gone away. I realized what was happening and instantly stopped, but the cravings (fortunately only mild at this stage) took a few days to go away. Scary, scary, drug, Oxycontin is.
SAMSHA is laying the groundwork to justify withholding prescriptions for opiates from people who legitimately need them, under the guise of “responsibility”. I benefited greatly from pain management with opiates for approximately three years. Sure, there are issues with suddenly ceasing use, which is why titration is important. Preventing those who seek to abuse any substance from doing so is not justification to allow people to live in pain. Look at the habit forming products that we allow to be sold: alcohol, tobacco, inhalants of all kinds, caffeine, the list goes on. People who are going to seek a high are going to find one - whether with bathtub crank, huffing glue or huffing air freshener. Preventing the inevitable dumba$$ from killing himself can not justify narrowing the definition of who gets opiates to help with pain.
I had a debilitating back injury, and my primary care physician was of the mindset that it is not in his interest to actually assist with pain management and refused to prescribe anything more effective than darvocet, at the time - stating that the pain is not as bad as an addiction could be?!?!?! If he only knew! I was sent to a neurosurgeon who understood the gravity of the pain, and responsibly managed it with me. Without opiates, my life would have nearly ended - the pain was of that magnitude.
I was getting iv dilaudid every three hours for five days while waiting for a kidney op. Between the vicious headaches and perpetual hyper-pareidolia, I hope I never see the damnable stuff again.
I’m sort of lucky. If I take any opiod for a week or so, the only effect is a splitting headace and I don’t seem to get a craving at all. On the other hand, aspirin works on me better than opiods, like magic. Better than Oxycontin, which I found rather lame.
I guess I am really lucky, was prescribed Vicodin for migraines for over thirty years and had no problem not taking them or stopping. I know some people have a more addictive personality than others, that’s why we have smokers that can’t quit and alcoholics.
I suffer from psoriatic arthritis and take Vicodin along with another pain killer plus Enbrel on a regualr basis. This is a disease with no cure and I would rather be addicted to a painkiller than to have to suffer everyday and not be able to live my life. That said, the most important part is to not exceed the dosage your doctor recommends. Once you start pushing against the boundary, then you are in big trouble.
Although not generally discussed or credited, many if not most people do not fall into addiction even when the opportunity is present. Genetic and epigenetic factors that influence the biochemistry of behavior seem to be at work to a large degree in susceptibility to addiction. The “addictive personality” is substantially an expression of those innate factors, with learning, experience, social mores, availability, and personal choices having a complicated and lesser role role.
” On the other hand, aspirin works on me better than opiods, like magic. “
Yes, aspirin’s a miracle drug for me too. It’s pretty much my go-to medicine.
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