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  • Opiates: Friend or Foe in the Fight Against Pain?

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    The business of pain is a difficult one. People suffer every day all over the world with horrible pain that seems like it can’t be resolved. As physicians grow busier and busier and the amount of chronic pain patients continues to grow the need for treatment is staggering. Low back pain, for example, is one of the leading causes of medical visits every year.

    Unfortunately, the huge need for pain relief without a proper understanding of pain mechanisms has led to a big problem: the careless prescription of opioid medications.
    This leads to the question…

    The reason opioid medications are used is because they are fast acting, extremely effective, and surprisingly cheap to produce. However, as is the general rule in life: “If it seems too good to be true, it probably is.

    All of these drugs produce a “high” that lasts anywhere from 15 minutes to hours. This “high” time is the effectiveness period of the drug. The depressant effect on the brain is why it is able to “numb” the pain… in reality it makes your nervous system respond slowly so that things it should normally notice aren’t important anymore.

    The most common short-term effects are:

    • Euphoria
    • Pain Relief
    • Drowsiness
    • Sedation

    Unfortunately, after even just 3 days of opioid use there can be measurable levels of addiction.

    Nevertheless, the drugs are sometimes prescribed for the long term. Unfortunately, this is a very dangerous pathway…

    The long term effects of opioid medications are:

    • Nausea and vomiting
    • Abdominal distention and bloating
    • Constipation
    • Liver damage
    • Brain damage
    • Tolerance (the drug loses effect and higher doses are needed)
    • Dependence (using the drug even if there isn’t pain; addiction)

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    The trouble with use of any type of “pain killer” is that it isn’t targeting the cause of the pain. These medications should be used as a last resort.

     

    And, unfortunately, even though the design of these medications is to control pain there is an ironic condition that arises from chronic use: long term opiate use actually makes you more sensitive to pain!!!

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    The good news is that there is substantial evidence that treating chronic pain with a multidisciplinary approach gives positive results. A multidisciplinary approach utilizes a “team” that works together to attack a problem from many different angles.

    An example team that could aid a patient who is struggling with opioid addiction or chronic pain could be any combination of the following:

    • Medical doctor (to oversee prescription changes and monitor laboratory results)
    • Chiropractor (to address neuromusculoskeletal pain)
    • Physiotherapist (to begin safe and functional movements/exercises)
    • Psychologist (to address addiction and emotional connections to the pain)
    • Nutritionist (to address deficiencies in diet)

    If you or anyone you know is suffering from chronic pain and/or has a problem with opioid use, it’s important to bring the subject up with a physician.

    Conservative treatment, if warranted, should always be attempted and failed before long-term decisions are made. In the case that conservative treatment doesn’t work, you are no worse off than you were before– it’s worth the attempt.

    Wishing everyone a happy and healthy week,

    Dr. Stephen Shinault

     

    Help Information for Opioid Addiction

     

    http://drugabuse.com/library/how-to-help-an-opiate-addict/

     

    Patients Seek Alternatives to Opioids

     

    http://www.npr.org/2016/08/01/488269407/patients-seek-out-alternatives-to-opioids-in-treatment-of-chronic-pain

     

    Multidisciplinary Treatment of Chronic Pain (sciatica)

     

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656892/

     

    Opiate Effects

     

    http://drugabuse.com/library/the-effects-of-opiate-use/

     

    http://drugabuse.com/featured/the-effects-of-opiates-on-the-body/