Chronic back pain

Narcotic Drugs for the Treatment of Chronic Pain: A Double Edged Sword

Morphine Prescriptions ImageIn the past, usage of narcotics was limited to acute situations of severe pain (i.e. trauma or post-surgical pain) because of the potential risk of addiction.

However, over the past decade, it has been felt that the risk of addiction was overstated, and that the pain relief for patients suffering from chronic pain was more important than the potential risks.

Change in mg of Morphine per Person (see reference 1)

Narcotic medications have, however, continued to be a double edged sword, and although they work well as a painkiller, they are usually only effective for short durations of time (weeks).

Rising Prescription Pain Medication Deaths

The consequence of this sea change in medical practice has been nothing short of disastrous. Recent estimates are:

  • 6 million Americans a year abuse prescription pain medication
  • Deaths from overdose have risen to 15, 000 people a year2

To put this in perspective, more people are dying every year from prescription pain medications than from heroin and cocaine combined.1

We can make the steroid supply safe again, but pulling back from widespread narcotic abuse will be much tougher.

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Painkiller Tolerance and Addiction

To be certain, not everyone who takes narcotic pain medications is an addict.

Most patients will develop some tolerance to the medications if they use them for more than 2 to 4 weeks, and if taken on a daily basis for any longer than this time period, most patients will also develop some habituation (urge to continue taking the medication on a daily basis).

In patients who have developed a tolerance and habituation, they will have withdrawal symptoms when they discontinue taking the narcotics. This withdrawal process is a natural consequence of taking the medication and does not mean that the patient is addicted to narcotics.

Pain medication addiction is a more complicated process. It involves manipulative behavior to obtain narcotic medications and a refusal to discontinue a medication even though it is no longer being used for a medical purpose. Some, including those at significant risk of overdosing, will go to multiple doctors to get medications.1

Many addicted patients will go through a cycle of needing more and more medication in order to keeping getting the desired effects of the medication.

Abuse of narcotic medications defined as taking more than the prescribed amount and although all addicts are abusers, not all abuse is done by addicts (i.e. one time use of someone else's medication for recreational purposes).

Many patients fall into the trap of assuming that if a medication is prescribed by a physician it is therefore safe to take. Physicians themselves often are responding to a request by a patient to get a prescription to relieve their symptoms. The process often starts off innocent enough, but then spirals into a never ending circle.

How Painkillers Work

Narcotic medications work in a very similar manner to heroin, and even bind to the same receptor (the Mu receptor) in the brain. Our bodies make our own narcotic-like molecules (endogenous endorphins) that can bring about a feeling of well-being. An example of this is the "runners high" that people get after a hard workout.

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Chronic back pain, 20m, need $$ help

by nickybum

Im looking for some help and support. I have chronic back pain that i have had since i was 16 years old when i had a spinal fusion to correct scoliosis. The scoliosis was caused by a chiari 1 malformation that was removed when i was 5 and caused a major curve in my spine. The surgery was done in fear that the curve would progress and curve into my lungs. I am in pain all of the time and the pain is intensified by sitting or standing for any periods of time. I have seen several doctors and none of them have found a solution to reduce the pain significantly enough for me to support myself. Im really out of thoughts and am desperate

I have chronic back pain..

by supercallie

Dr thought RA but when I went to a specialist he felt like my RF factor wasn't high enough for it to be RA and DXed me with fibromyalgia.
HOWEVER the pain is in my lower back and the pain radiates down to my legs and feet. I get tingling and numbness and even paralysis sometimes.
I'm just skeptical about it being FMS when the pain is MOSTLY in my back.
I am going to get a second opinion when I get health care but until then I am trying acupuncture.

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He also emphasized the importance of behavioral health, noting a 2003 study which found that patients with chronic back pain benefited equally from back surgery and from psychological treatment. See Comments. Read more in Healthcare. Sponsors.

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