Study: Don't Avoid Opioids to Treat Back Pain

WMUR-TV ^ | March 14, 2003 | By Holly VanScoy

[Cold Heat]

We have just GOT to get over this knee-jerk reaction to drugs

I think that in this case, it is not the drug, nut the dirty word called addiction.

This word bothered me as well for a couple of years into treatment, but as I came to accept my condition, I accepted the addiction as a side effect and not a disease.

I have no other options except to die.

That would be the end result of the depression that would ensue if I did not take the drug.

This is about as clear as I have ever been about this point. I understand what happened to Rush very well.

[alloysteel]

There are those who say that Rush should not be out swinging a golf club, if his back is as bad as claimed. That the medication is only for feel-good, not for therapy.

Be aware that a really debilitating back injury is sharply acute and seriously limits range of motion, not because the muscles are unable to make the motions, but because it hurts so DAMNED much. The difference between this constant pain and near-total relief is akin to releasing a grip on a high-voltage electrical source. When the pain is at its peak intensity, a person is not thinking about much else, and who wants to be at the mercy of such seemingly unending torture? Unceasing pain can be a major contributing factor in stress-induced depression, and depression leads to the downward spiral to self-immolation. At a certain point, a person may not WANT to live any more. Almost anything that causes the pain to recede is welcomed, and some of the narcotics available seem to do a reasonable efficient job, with a minimal reduction in judgment and limited hangover effects.

Make no mistake. Under the influence, the patient is still impaired, but the pain causes even more impairment.

[Cold Heat]

Nut =but (sheesh)

[Plutarch]

It appears in the latest issue of the journal Pain Medicine.

Wow, the journal Pain Medicine. Real impressive. The medical world little notes nor long remembers what is printed in the pages of Pain Medicine. Pain Medicine is an organ of the American Academy of Pain Medicine, which derives much of its funding from the Purdue-Fredrick, the makers of Oxycontin. Pain Medicine is the equivalent of the Journal of the Tobacco Institute.

[eddie willers]

think that in this case, it is not the drug, [b]ut the dirty word called addiction.

I agree.
Diabetics are addicted to insulin.

An "addiction" is oftimes preferable to the alternatives.

[Cold Heat]

Pain Medicine is the equivalent of the Journal of the Tobacco Institute.

Ok, so it is all BS I suppose.

No, there are the same statements made in almost every medical journal.

Pain can be treated.

Why should someone be forced to edure pain when it can be mitigated?

Just common sense reasoning.

[Grenada]

You are comparing OxyContin and cigarettes? That's,um, nice.

[alloysteel]

So the Pain Medication publication may be considered a form of advertising? This is not a bad thing in itself, because we would not know about Vor-Tec engines used in Chevrolet vehicles, for instance, EXCEPT for advertising. Advertising, if used to communicate factual information about the product, is a wonderful educational tool.

[ChicagoHebrew]

It's actually a general problem with America. Most Americans fall into two camps on narcotics-- they either snort massive quantities up their nose for pleasure, or want to arrest people who do. They ignore the massive middle ground.

This summer I was in Peru and enjoyed many cups of coca tea-- made from the same coca leaves we get cocaine from. But in their natural tea-leaf form (it takes 2-3 leaves to make a cup of tea, about 3000 to create cocaine), they are totally 100% non-addictive, while still serving as a wonderful stimulant/mood enhancer/pain reliever. There are so many healthy, beneficial uses to these substances-- when used in the right doses and for the right situations.

[dix]

I had surgery to remove a cancerous tumor, and one quarter of my left lung on April 18, 2003. BTW I was a former smoker when all of this came up . I finished my chemotherapy about a month ago, had my three month CAT scan, and at the moment I am cancer free. There is just one lingering side effect, and that is the pain from my surgery. I take two and a half 750 mg. Vicodan a day.

My job requires me to do a lot of walking, and stair climbing, because I am a realtor who is working at an onsite condo development where I have to show the prospects the various units. If people want to call me a drug addict go right ahead.

When all of this started I researched all of the meds that I would be taking, and I learned about the possibility of addiction. I also learned about developing a tolerance, and I watch my dosage very closely. I have developed a bit of a tolerance, and I just opt for a little more pain instead of increasing the dosage. I think that is where Rush went wrong.

Hydrocodone gives you an incredible sense of well-being. You have to be aware of this, and keep in mind the object is to stop, or mute the pain. Not to go to la la land.


10 posted on 10/11/2003 7:30 PM PDT by dix

[steve86]

I take Ibuprophen (4 every four hrs) on top of it and it helps greatly.

Careful with that. I damaged my esophagus taking Ibuprofen (3 every four hrs) around the clock for three years. Even now, five years later, the injury has not healed.

[libbylu]

Isn't Vicoprofen still on the market??

[ConservativeMan55]

bump

[goody2shooz]

Oh boy. With my opinions I'll probably get flamed, but what the Hell! You see I have a defect in my spine, a third of all discs having now obliterated and I control pain successfully with excercise - NO PAINKILLERS.

On the other hand my sister and brother-in-law, ex-rock n' roll musicians, are addicts. Heroin first, then methadone. My sister had to go through rehab just to get off of three year's use of methadone, supposed non-addictive. The brother-in-law has been on methadone now for fifteen years, 200 milligrams a day dosage. Both started with tobacco and neither have been able to quit that habit either. Brain scans indicate whole areas of their brains as inactive.

The worst part is that both have developed hyper-sensitivity to pain. Yep. It appears that the more one uses painkillers, the lower drops one's threshold to pain.

I have tried to get to do what I do: aqua aerobics. Not swimming but walking and slow jogging through chest-high water works for me. It takes the trauma off the lower back.

[MattAMiller]

I was once presribed a cough medicine with condein, also an opoid, in it. It made me sleep so much I wasn't able to take the number of doses I supposed to take for a day. Not terribly useful for recreational purposes, not for me anyway.

[Sandy]

Without the 12hr time release version of Oxy-codone, I would be forced to take percocets all day long and the Tylenol would likely cause liver damages over time. I wish they would combine it with someting like Ibuprophen.

Percolone/Roxicodone/OxyIR are immediate-release oxycodone pills with no aspirin or acetominophen. You could take any of those if you'd rather not take the time-released stuff.

[MissL]

Never !!! That is why I cannot fault anyone for wanting to ease the pain !!!

[Sally'sConcerns]

I wish I could say I knew nothing about chronic pain but unfortunately, I do. Currently I take Panlor SS, fioronal, elavil and soma. I've been on one type of pain medication or another for 9 years. For 6 of those years I was able to continue working thanks to the meds. I worked even in the face of a pain phsycologist telling me I needed to accept I couldn't work.

In July, 2000 I could no longer work even though I'd try. I applied for long term disability insurance and was devastated when they approved my claim. During the approval process I kept hoping someone would tell me about a magic bullet. When the insurance company approved me, it was final confirmation that I was truly disabled and there was no cure for my pain.

Even after I moved to Oklahoma, I kept the same primary care physician because he knew my history. Together we had explored every option he could think of. I was referred at different times to 3 different neurosurgeons,an orthopoedic surgeon who specialized in spinal chord injuries, numerous physical therapists, 3 pain clinics and a partridge in a pear tree. Not one of the specialists recommended further surgery so that wasn't an option.

I've had MRI's, X-rays, dye injections and shots in the joints in my neck. They all agree my neck is a mess and they all agree there's nothing that can be done physically to relieve the pain.

I mentioned I had kept the same physician once I moved to Oklahoma because it has a bearing on how chronic pain is regarded by the medical community. Once I decided to find local doctors I ran into the following problem. I'd call a doctor and ask if they were accepting new patients and if they were, whether they accepted Medicaire and my supplemental insurance. Once that was answered in the affirmative they'd ask me if I had any diseases or ongoing problems. I'd answer, yes, I have chronic pain and have been under the same PCP's care for 9 years. The answer I'd get is.....We don't accept patients who have chronic pain problems.

So, that's all I am. Just a chronic pain patient. I'm not someone who gets a physical every year, I'm not someone who occasionally gets bronchitis, I'm not someone who gets sick or ever needs a doctor for any reason other than I AM A CHRONIC PAIN PATIENT.

My whole identity to the medical community is I'm a chronic pain patient and they don't want anything to do with me.

Fortunately, my dog had been hit by a car on mother's day and he'd bit me so I'd gone into get a tetanus shot and antibiotics. I was able to utilize this back door to establish myself as a patient with a local doctor. Of course, once I made the decision to have my records transferred,the doctor's office tried to discourage me by telling me they don't prescribe pain medication. I reminded them I hadn't gone to them initially as a chronic pain patient so they finally agreed to become my PCP. I scheduled an office visit and was referred to a pain management specialist who is willing to help me manage my pain.

Is this not ridiculous? Nine years with the same Primary Care Physician managing my case and I'm treated as if I am an untouchable. Not only do I have to deal with the pain but my identity has been stolen. According to the medical community, I'm no longer Sally, I'm a CHRONIC PAIN problem.

[Myrddin]

I take Ibuprophen (4 every four hrs) on top of it and it helps greatly.

When I lived in San Diego, I was an avid inline speedskater. One of my fellow skaters was an orthopedic surgeon in his 50's. He skated 20+ miles everyday. He suddenly ceased skating for almost 3 weeks. When he returned, he shared the reason for the hiatus. He was taking ibuprofen on a daily basis to control the pain from skating. It blew out his stomach. He was on the operating table for 3 hours getting his stomach fixed. He consumed 9 bags of blood during surgery. All the skaters were happy to see him return, but we also paid attention to the consequences of overindulgence in ibuprofen.

I had one good year skating at the lake. Normally, I have pretty bad pain in my back, knees and ankles. It makes skating or walking around painful. My doctor prescribed a nasal spray cortico-steroid called Beconase for my sinus problems. After 3 weeks of use, the pain in my back, knees and ankles was gone. I progressed from hobbling around the 5 mile road in 38 minutes to 15 miles non-stop in 66 minutes. When the Beconase ran out in September, the 15 mile trip extended to 72 minutes because the severe pain returned in my back, knees and ankles. After a few weeks of continuing pain, I hung up my skates.

Today, the only relief I get from my back pain comes from a single Naproxen tablet and a 12 ounce bottle of Killian's Red. It works fine, but that is reserved for after working hours. I just have to bear the pain in my back, knees and ankles during work hours. Three 200 mg ibuprofen with Killian's works too, but not as long. Any relief is welcome.

[Ursus arctos horribilis]

Three back surgeries, four fused lumbar vertebrate, two 9 mm rods and eight large screws later. I wish I had taken pain relief meds long ago. To the tough guys and gals who say they manage just fine without pain medication. Stick both hands over an open flame until you get that sudden urge to pull them out. Now tell me why you couldn't handle that little gambit.There is pain, then there is PAIN. When you get the PAIN, believe me, you won't confuse it with pain.