Pain management

This is a long post, so I have broken it into two parts for easier reading.  In the first part we will discuss opioids and common side effects and in part two, we will look at the medical society’s “crack down” on prescribing narcotics, as well as the effect of opioids on the human body when used for long-term pain management.

When you live with chronic pain and have surpassed the point where over-the-counter medications, such as Tylenol and Advil no longer relieve your pain, you may be prescribed a narcotic in a class of drugs called opioids.  “Opioid drugs work by binding to opioid receptors in the brain, spinal cord, and other areas of the body. They reduce the sending of pain messages to the brain and reduce feelings of pain.”  These drugs include medications like:

–        Oxycodone

–        Hydrocodone

–        Morphine

–        Fentanyl

–        Hydromorphone

–        Methadone

I have recently written several articles about the psychological aspect of being on pain medication, including the poor treatment and judgment I often receive as a result of being a “pain management patient,” however, the difficulties associated with taking these medications can go far beyond the stigma attached to taking narcotics.

Side Effects of Opioids

These sometimes helpful pills and patches can come with a plethora of annoying and problematic side effects.  Common side effects of opioids include:

–        Constipation.  My pain management doctor asked me if I was “doing poopys” regularly because a lack of proper bowel functioning can actually make a person go crazy.  Since I have been dealing with that for almost 2 years before a doctor suggested Lactulose for regularity, I can attest to how terrible this side effect can be.  Worse yet, it can lead to bowel obstructions.  If you take narcotics, it is highly suggested that you ask about daily laxatives if you are not already on one.  Surgeons and general physicians do not always think to put a patient on something like this.

–        Dizziness.  Use caution, especially when driving, as this can come on suddenly.  I have found the dizziness lessened with time, but still happens occasionally.  Everything affects these medications, even things like how much you have eaten, what you eat, etc.

–        Drowsiness.  This is the hardest side effect to deal with because a BIG part of healing and dealing with pain is physical therapy.  When you are taking medicine around the clock that makes you tired, getting up to workout, work, or do anything is like adding another pound to the already heavy weight most of us are bearing.  Caffeine is not very effective in combating this and I often find than just trying my hardest to get up and MOVE is most helpful in propelling me forward…momentum!

–        Nausea and Vomiting.  This has been both terrible and helpful since the nausea helps with appetite control.  However, constant nausea can be very difficult to deal with and I often try tea, eating crackers or pretzels and sucking on little candies to combat this.

–        Drug  and Alcohol Interactions.  These little buggers may help with pain, but they tend to interact with a lot of other medications, especially those for depression, allergies, sleeping pills, even birth control.  Check with your doctor or pharmacist before taking anything. Also, avoid alcohol as much as possible as it definitely interacts with these medications.

–        Dry Mouth.  It’s like having sandpaper between your lips. Water does NOT help with this side effect.  I have constant dry mouth and often drink like a fish, especially if I have to speak in front of people.  I have found the most helpful solutions are the dry mouth gums and sprays and I am constantly sucking on cough drops, mints, etc.

–        Tolerance and Addiction.  How can we forget about the fact that we might get addicted to these pills when TV commercials now warn us about the dangers of taking pain pills during the 5-o’clock news?  For my rant on that, you can see my previous articles on narcotics and stigmas, but these are unfortunate side effects.  If you use your medication correctly, addiction should not be an issue, however, opioids are a class of drugs that your body is relatively quick to build a tolerance to, which is what often leads to misuse.  If you feel your pills are not working well, always talk to your doctor.  Never change dosages without speaking to your doctor.

It is important to keep in mind that not all side effects happen to every person and some may lessen as your body adjusts to the medication(s).  If a side effect is particularly bothersome, NEVER stop taking this medication without talking to your doctor as that can have serious, even fatal consequences.  Stopping opioids has to be done in a controlled manner to avoid serious injury.

Although not a side effect, another difficulty in living with narcotics is obtaining them.  Insurance covers pain management, but in my case, the only doctor who was willing to work with a complicated case is out-of-network, so my co-pays are outrageous.  Since these are highly controlled substances, it also means that you MUST see the doctor every month in order to remain on them.  This can put an additional financial strain on many people whose budgets are already stretched thin due to high medical costs.  Try talking to your doctor about your financial situation to work out a payment plan or see if services are offered at a reduced rate.

Stay Tunes for the rest of the article on Thursday…