Pain management

I apologize for the absence.  Unfortunately I had a lot of pain and back issues following my car accident a few weeks ago, which landed me in the hospital for 6 days.  It was a less than optimal way to spend my birthday, to say the least.

In any case, here is Part 2 of Living with Opioids.  For a recap, visit https://blogs.psychcentral.com/chronic-pain/2013/06/living-with-opioids-part-1/

Last article we talked about the side effects opioids has on the system, but now we look at a common complaints I have heard from many people- obtaining narcotics and not being believed that their pain is real, as well as what affects long-term opioid use can have on the body.

The medical society has made narcotics into such an “evil” class of drugs that many doctors have such strict rules that they cannot, or choose not to help people in pain.  I was “punted” to so many doctors before I found one that would take me because, like people in love, doctors are afraid of getting hurt.  My first interview with my pain management doctor felt more like an interrogation of both myself and my husband.  I was scared when I left.  I was ordered to give a Urine Drug Screen, put on “probation” and left terrified of how this was going to go every month.

My pain management doctor is actually a very funny and nice man, but his treatment of me makes it clear that he has “been burned” by drug-seeking patients in the past, and therefore everyone is suspect until proven otherwise.  It is sad that there are people who try to cheat the system and, by doing so, make it so difficult for those of us who truly need help.

Of course, in talking about these pills, we cannot forget to mention the physical toll they take on our bodies in the long run.  Long-term use of opioids for pain management can be harmful to multiple organs and the effects on the body can include:

–        Affects on the immune system, including higher rates of infection.

–        Decreased libido and difficulty in sexual functioning.

–        Decreased testosterone (men)

–        Osteoporosis

–        Changes in hormones and menstrual cycles (women)

–        Sleep Disturbances

–        Psychomotor Performance

–        Fertility Issues/Birth Defects if taken when pregnant

–        Bladder dysfunction

–        Mood Disturbances

–        Liver damage (when combined with NSAIDs and over-the-counter medications like Tylenol)

–        Cardiac Damage (not very likely, but possible)

–        Hyperanalgesia.  This is a big word for basically every tiny pain you feel is amplified and feels like a 100 on the silly 1-10 pain scale.  This is a result of your pain receptors getting confused from chronic use of opioids pain medications.  The unfortunate problem that accompanies this is that your pain medication becomes less and less effective and therefore dose increases are required over time for the medication work.

It’s a scary list when you see it put in front of you like that.  I often wonder what will happen to my body in the long run because of these medications…but at the same time my body cannot withstand the pain so there is no option at the moment.  I try to do what I can to detoxify and cleanse my body regularly, whether with herbal supplements, eating as healthy as possible, exercising, etc.  There is not much you can do, however, to clear this medication from your system without stopping it from blocking the pain.  Stopping narcotics brings about a whole new set of problems as long-term opioid use has been known to have a brutal and dangerous detox.

If your chronic pain condition requires you to take these medications, my best advice is to always keep an up-to-date list in your wallet or phone and make sure all your doctors, specialists and surgeons have a copy, as does your pharmacist.  If you have allergies, make sure that is noted in all medical records.

You are your own best advocate, so you are the one who needs to keep track of your medications and the side effects that they are causing that may be bothersome to you.  You are the only one who knows how you feel, so it is up to you to tell your doctor everything that is going on.  Doctors may hold the power to prescribe, but only you know how you really FEEL and it is important to convey that to them so they can figure out how best to help you.

As a final note, do NOT let others opinion of your medication stop you from getting help.  Yes, there are many commercials and brochures talking about the evils of prescription drug abuse and how bad narcotics are, but they are effective and sometimes, necessary.  If others have something to say about your choices, kindly remind them that they do not walk in your painful shoes and therefore should reserve their opinions. Your body, your choice.

As a side note- if you are like me and you have to carry medication with you all the time, I found a cool site that makes nice, sturdy key chain pill holders so you can discreetly carry and take your pills when you are on the go.  Check it out at http://www.thepillholder.com/

Resources:

http://www.webmd.com/pain-management/guide/narcotic-pain-medications

http://www.painphysicianjournal.com/2008/april/2008;11;S105-S120.pdf

http://ohwhatapain.wordpress.com/being-treated-like-an-addict/