Use and Abuse of Prescription Painkillers
http://thedianerehmshow.org/shows/2011-04-21/use-and-abuse-prescription-painkillers
Public health experts say the abuse of prescription medication is the fasting-growing drug problem in the United States. A new Obama administration initiative aims to reduce addiction levels by 15 percent over the next five years. Among others elements, it would require doctors to receive special training for prescribing painkillers. Many in law enforcement laud the proposals. But people who need powerful drugs to manage chronic pain are concerned. They fear tougher rules for physicians will make it harder for them to get relief. An update on what's being called a public health epidemic.
Guests
Dr. Paul Christo
director of the Multidisciplinary Pain Fellowship Program at The Johns Hopkins Hospital; former director of the Blaustein Pain Treatment Center; host of "Aches and Gains," a weekly radio show in Baltimore.
Dr. Nora Volkow
director of the National Institute on Drug Abuse of NIH.
Charles Horner
chief of police, Portsmouth (Ohio) Police Department.
Dr. Robert Dupont
president of the Institute for Behavior and Health; former director of the National Institute on Drug Abuse.
Comments
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I was one of those people and quit just fine.
Mainly due to Rush Limbaugh being in the news as addicted and there was no way, shape or form I wanted to be anything like him.
The argument about addiction to pain killers for the euphoric high is upside down for long term users.
For me, with chronic back pain, any addiction is from constant withdrawing. Long term usage has caused me to be sick of the euphoria as it is not 'normal' and interrupts your life.
For example, I am prescribed 4 pills a day. Most people, including physcians do not realize the pain relief effect follows a bell shaped curve.
It takes time to react and within a short time begins to gradually wear off. So after the initial relief I am experiencing constant mental and physical withdrawl symptoms. I find my self taking another pill just to combat that alone.
Also, I get 6 hours sleep per night. The prescribing physician calculates 4 pills per day at 4 hours each = 16 hours leaving 8 hours of sleep. So every day I battle to keep from taking another pill because of my sleep habits.
Because of the type of pain I have I am not always in pain. But to drop the dosage is a major change due to the withdrawal symptoms.
It severly disrupts my work day and personal affairs. As a result I must take the 4 pills per day just to keep a steady state of mind regardless of the level of pain.
Also, I refuse to take more or stronger doses because of the tolerance factor. You get yourself into a worsening situation as you become tolerant to higher and higher doses. Soon you are no better off and now battling worsening withdrawal symptoms.
So it is a constant 'managing' of my medication. It is not fun but it is necessary.
Unfortunately too many doctors do not view it from that standpoint and listen to Dr's such as your guest who is on the addiction counsel who tells them the opposite of the real truth for those who really need the medication. She speaks of those who abuse the medication and unfortunately this leads to doctors believing, because she has a title, what she says instead of the patient.
I am a recovering prescription pill addict. I am also a suburban stay-at-home soccer mom. I am part of a huge demographic of people who are not your stereotypical addict and I never thought it could happen to me. It's been a long road and I still have tough days. I can honestly say that the support of a 12-Step group is a huge part of my recovery from the disease of addiction. There are two Pills Anonymous meetings in the DC Metro area. One is in Springfield, VA and the other is in Frederick, MD. These meetings are FREE. Pills Anonymous is a 12-Step fellowship that focuses specifically on prescription pills addiction for addicts, friends and family. For more information about prescription pill addiction and the addresses of the meetings you can go to the Pills Anonymous national website at www.pillsanonymous.org.
Today's A+ program on Drug Overdose inspired me to seek the topic more:
This response is accurate, 8/25/10 DR Show. I can not believe Dr. Benson is not aware. Please, Dianne Rehm, please do a show on EMDR IA.org Eye Movement Desensitization Reprocessing. I spent one year, 4 hours a week for over a year with a certified psychotherapist, UM PhD, by the EMDRIA.org an international association. The emotional pain is intense and debilitating.
Susan Kolbe, 8/10, above is correct with her information. Little or nothing is respectfully known or understands this incredible, positive therapy. It Works!
NANA Ed.S Reading; suffered a rape, sexual assault felony, Jan. 2007, caused a PTSD response diagnosed, treated and on medication professionally.
Response to April 21 show on Drug Overdose - the wrong choice for help!
The distinction between addiction and physical dependence on prescription drugs is one that often gets lost. Many patients resist taking opioids because they fear becoming addicted. However, this is not the case.
I am very concerned with how flippantly this panel dismissed the theraputic qualities of cannabis. Personally, I don't see how anybody can discuss opiate pill addiction and exclude cannabis from the debate. It has been PROVEN that cannabis is not physically addicting as opiate perscription pills are. If withdrawl symptoms ever arise (and it is a rarity when they do) they are comparatively non-existant to those caused by pills such as oxycotin or vicodin.
Even the National Institute for Cancer, a federal institution, has admitted that cannabis can have profound theraputic effects for patients with a broad spectrum of ailments. It even admitted that several studies have shown that cannabinoids have DIRECT ANTI-TUMOR PROPERTIES (unfortunately, this information was pulled from their site 11 days after it was posted).
The director of NIDA herself admitted that there needs to be more research into medicine that isn't so destructive. Why is marijuana so easily dismissed by these people who claim to be working for society's collective health? NIDA has publicly stated that it refuses to do any research on this medicine because its mission is only to find NEGATIVE health effects caused by it. When research ends up confirming that cannabis is an excellent medicine, they pull the research's funding immediately.
The agencies our government set up to regulate our medical industry are blocking research into a medicine that HAS THE POTENTIAL TO CURE CANCER.
It baffles me that no one is as pissed off about that as they should be.
I had knee replacement 2007 and 2008 6 months apart the first surgery I was threatened if I didn't take opitates for my recovery. I caved in unfortunately and the recovery was very hard. The second surgery I took only local for my pain the second surgery I recovered faster and better. I think we are a society of whinners. I think we could handle a lot more pain than what docs think we can handle.
my prayer is that the many people who have commented and participated in the show today, find healing in the holistic practice of chiropractic. although opiates and strong pain killers do play an important role in our health from time to time, the truth is that many if not most painful chronic conditions can be helped, and outright healed, by regular chiropractic intervention. chiropractors have healed me from chronic neck and shoulder pain and have saved my life. the body is one large system of electro-chemical impulses and outside chemicals that are introduced can disrupt the delicate balance needed for health and healing of living cells. when the central nervous system is interrupted from spinal subluxations, nerves are pinched, etc., the body reacts and eventually manifests in pain or disrupted optimum health. Diane, PLEASE consider doing a show of the healing power of chiropractic and holistic healing!!! thank you for the amazing awareness you provide to our community!
Reactionary hysteria is as popular in the U.S. as McDonald's, evidenced by the drivel that's peddled nightly on cable outlets, draconian drug laws, etc. Opioids are demonized despite being remarkable in their low incidence of side-effects and their efficacy - not only in physical pain relief but also in treatment of depression, anxiety, and mood disorders. But it's hardly surprising, since something as benign and therapeutic as cannabis is demonized, too.
People can bring .45s into bars and drink away, cigarettes have the green light, an endless parade of people on happy clouds and potentially dangerous drugs of the multi-billion pharma industry float across TV screens every 10 minutes.
Some can deal with some types of pain. "Whining" doesn't apply as well to debilitating conditions that affect nerves, mood, etc. Conditions and people vary and St. John's Wort and medidation just don't quite do it for everyone. So I do know of a few people with chronic conditions who have been denied treatment for years - one told that treatment was against policy and briefly managed to see a doctor who didn't cave to the pressure to deny treatment, while one was offered expensive surgery.
So, Hamilton, are you a follower or a fan?
I am special because I live each day as if it were my last.
I do that because I suffer from dwarfism as a result of a medical error when I was 9. Dwarfism means I have organ crowding, abnormal joints, extremely short stature and other skeletal problems. In addition there are hormonal complications. I have lived an exceptional life as an actor and a Senatorial aide. I have made and lost 4 fortunes. At present I secure a high income as a commodities speculator in everything from petroleum to apple juice. I have been happily married to another "little person" for only 5 years coming in July. If anyone is an expert on pain and avoiding and curing addiction I am. If anyone is a political and economic insider, I am. If anyone is a patriotic advocate of full democracy, I am.
My obituary will roll over most like an open can of whoop-ass. Glad to have you as a critical admirer. Thanks for reading my stuff.
I was born with Cystinuria, a rare, painful condition that causes me to have constant kidney stones. I pass small sharp stones daily, and have had over 25 surgeries to remove large stones starting at age 3.
It wasn't until I was 30 that I was advised to go to a Pain Clinic, where doctors who were trained in Pain Management would treat me and help me bring my pain to a level that I could live with.
I have suffered all my life, and for years I sought the help of doctors who treated me like a liar, a fake, and a drug addict. Often the treatment prescribed did more harm than good.
My own research led me to a Pain Clinic, and that decision changed my life. Here is the revelation that took me years to learn: most doctors do not know how to treat pain.
Doctors want to find a problem, treat it and move on. If they can't find the source of pain, or if their 1st or 2nd treatment doesn't work, doctors will tell you that you need to see a different doctor, or you should learn to live with the pain. Patients end up going from doctor to doctor seeking relief, and accumulating prescriptions that, if they are lucky, give them a few hours of relief.
Train doctors and nurses to identify chronic pain and direct those suffering to the correct treatment and I think this will lower RX pain med abuse.
It seems many are very mis-informed about the differences in dependance, tolerance and addiction within the relm of opioid use.
Tolerance - when a person has been taking a medication (any medication not just opioids - anti-depressants for instance commonly have this problem) for a period of time and the medication becomes less and less effective requiring an increase in dose to get the same effect on symptoms.
Dependence - when a person is trying to stop a medication (again not just opioids as anti-pain mngmt "experts" would have us believe) and they expereince withdrawal symptoms - this is NOT a sign of addiction but unfortunately to many health care providers say it is due to either ignorance or lack of understanding. The solution to this is to taper off of the medication slowly under physician guidance and when there isnt guidance then talk to ones pharmacist for assistance on how best to taper.
Addiction - this is the behavior of seeking out medications either through illegal means off the street, stealing from family, friends, etc or by any other means such as impersonating a fake patient with made up symptoms in order to get medication and improperly using medication.
This said I strongly reccomend to ALL pain patients - LOCK UP YOUR medications!!!! And to those who believe pain isnt a problem - live in a pain patients shoes once for even a few days and see how well you function! An abuser will always find their next fix - a legitimate patient will always suffer because of the hand a abuser chooses to play and because our Govt and bureaucrats chose to be mis-informed on what benefit these medications have on real living patients with chronic pain!
ericajth: I think your categorical definitions are wise assessments. However, I would add that the intense profit motive in medicine and pharmaceuticals makes the problem of uncaring far worse than it need be. A comprehensive federal system of treatment delivery would help. I like to compare drug sales promotion and their resistance to regulation to that of gun marketers.
Cfaucette: You have shared the necessary irrationality of "doctor shopping" for those of us with less common ailments.
Because of time constraints and the fear of being unmasked as not knowing doctors stick to a 10 minute maximum of individual patient exposure and a McDonald's menu of medicine. With your kidney stone condition being chronic I wonder if you've ever investigated or used lithotripsy, the use of focused ultrasound to break down kidney stones so they won't become lodged and cause intense pain. I have had the procedure. It avoids stents, invasive surgery and infection risks. I know from experience that lodged kidney stones can be intensely painful and can damage the kidneys with blockages so I sympathize with you and hope there will be some systemic remedy for your condition. I admire you for your persistence and your pain management successes.
I am infuriated by the guests on this program. They are in complete denial of the central role of physicians in the prescription drug epidemic, they demonize people who become addicted ("those people" who get the drugs from outside the system and who use other drugs at the same time), and they are completely ignorant of the disorder of addiction. I am horrified that people so ignorant of addiction have control of these devastating drugs.
All three of your guests put forth the notion that all a patient has to do is be honest with the physician, and if they're not honest whatever happens is the patient's fault. People who suffer from addiction cannot be honest. That is the most fundamental element of addition. So your guests are saying, if a physician gives drugs which lead to or perpetuate an addiction, due to the addict's dishonesty, it's the addiction's fault. That's a very convenient rationalization, one which assures the prescription drug epidemic will continue to spiral out of control.
I don't think any of your guests actually practice in the field. I can go to any emergency room any day, tell them I have pain, and receive opioid pain pills. I have gone with my addicted family member and pleaded with the doctor, please, don't give her more drugs, it is tearing the family apart. The response is, the doctor cannot pay any attention to me because of privacy, and the drugs are given.
Your guests are firmly entrenched in the heart of, and are the prime cause of, the problem. This is a case where I think you brought three voices from the same camp, and perhaps another show is warranted to bring balance to the conversation.
Opiats are the only narcotic that has NO [lasting] PSYCHOLIGICAL effects, also it is balanced by CLASS, lower classes beware [beer for you], Higher Classes UNDERSTAND that addiction is like debt, NO NO.
I have increasing Pain for 5 + years now -often very bad and "tone " affecting, however the only "prescription painkillers" I've had [too few and months now] I'v stolen...[borrowed?] from moms or brothers/his wife? ....stash?
when I even concider asking a doctor for something strong I feel like a laughter volcano [bong slappy] and I burn every bridge there is [California style]
The more important distinguishment is between true opiate and "synthetic" as "hydrocodone is???]"-pain in the dark types anxiusly [humar me this]
The latter or synthetics [i believe] are MORE ADDICTING while the true oppiats are more strong/nausiating/narcotic...,. That is after taking "hydrocodone" -2 to 3- months latter you feel you MUST have more, while codien is more like [also/too] DO NOT DRIVE MACHINERY.... but then forget it.
Also it's very interesting Culturally that in ENGLAND, AUSTRALIA & IRELAND "low grade opiates" are OVER THE COUNTER -no prescription needed, but if you take "enough" you'lll feel sick or risk your liver, so a little is ....normal? culturally, in GERMANY it is NOT THE CASE rite? [fuzzy memory][germans might be too eager...] this is the extent of my travels and I only know what I've seen & HEARD... don't "RUSH" to conclusions until you know WHO & what.... you're dealing with, then [is???] it's party time babey -joking...so easy. but NOT SCHITZO like "it's o.k." canabis / pot -are you crazy? why certinly.
I'm dreaming of goood sleeeep. in pain. for now, LIVE Long time babey -B.S. on tap, ask not, stealth.... winners are careful [my Aunt was/is foolish]