Dr Norman Doidge ~ is an MD and Psychiatrist based out of Toronto Canada that has written some very good New York times bestsellers, on the emerging science of Neuroplasticity. Chronic Pain patients have traumatized CNS ( central nervous systems). In this fascinating book, Dr Doidge explores ways of rendering the damaged pathways useless , creating NEW pathways that are pain free. THUMBS UP ! Must read for anyone with pain or their loved ones and family.
Opioids may not be the most harmful pain drugs after all…Michael Vagg Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health
We have seen plenty of media reporting of the harm done by “overprescribing” of opioid drugs for chronic pain (I use the quotation marks because I challenge anyone to identify what the “right” level of opioid prescribing is) but perhaps this hype is misleading. A new paper from a Melbourne research group suggests we may be looking in the wrong spot for the worst harms.
In this study, published in the journal Pain Medicine a scale for rating medication-related detrimental effects was used to assess a sample of 224 patients being treated at a large metropolitan Melbourne pain treatment centre.
Some patients were only taking one prescribed medication, a few were taking as many as nine. The average patient was taking three medications, with some 80% taking at least one opioid drug. The authors were able to identify five groups within the sample. For those interested in such things, the statistical methods used were quite clever, and worth a read of the full text.
Interestingly perhaps, the smallest of the five groups was those suffering above-average harm from multiple drug classes (5% of the sample). The largest group suffering above-average levels of harm from their medications was the 34% of patients in the sample with problems from the “simple” analgesics such as over-the-counter paracetamol, codeine, ibuprofen and similar preparations. The next largest group were experiencing above-average detriment from non-opioid drugs used for pain such as pregabalin (Lyrica) and amitriptyline (Endep). The opioids came in third at 20% with the other group being combined opioid and benzodiazepene harm at 14%.
These real-world results are fascinating for a couple of reasons.
The first is that they go against received wisdom that opioids are the source of all evil in pain prescribing. I am not disputing that deaths from inadvertent opioid overdoses have increased in the last decade, this has not been in proportion to the growth in prescribing. And while we have been paying attention to the sobering Coroner’s figures on tragic deaths, we may have been looking right past a whole cavalcade of grief caused by codeine addiction, ibuprofen-related gastrointestinal and kidney injury and paracetamol-related liver problems. Not to mention the fractures and other injuries caused by falls, car accidents or workplace incidents due in whole or part to side effects from adjuvant analgesic drugs.
Another reason I’m intrigued by these results is that they are in accord with my own clinical experience. As a rule I have learnt to distrust any research which confirms my own prejudices. This study tends to support my own experience in the clinic where I have observed that non-opioid analgesics cause at least at much adversity to patients as the much-maligned milk of the poppy.
The third reason I like these results is that they tend to support my belief that chronic pain sufferers are not opioid-seeking pleasure fiends, but desperate individuals who are looking for relief. Opioids are capable of providing some people with better quality of life if carefully used. We also know that this is not the case for the majority of chronic pain sufferers. Whether intentionally or not, the literature on prescription opioid issues in both the media and professional journals contains a thread of judgement that does not mirror the people I meet every day of my working life.
It’s rational to seek relief from pain, and if all someone has found even partly effective is an opioid, well why wouldn’t you ask for more of it? I have a solid minority of patients who obtain valuable relief with more than acceptable side effects from opioids. These benefits enable them to work, spend time with their children and grandchildren and other worthy goals. It’s not my experience that opioid-related problems are inevitable or that they don’t have any value under any circumstances.
I think addiction specialists and pain management specialists see a different spectrum of customers. Most of the patients I see would much rather be on less medication than more. They are poorly served by a system which facilitates prescriptions and over-the-counter solutions while making it hard to access pain education and interdisciplinary care. According to an old medical axiom, if all you have is a hammer, every problem starts to look like a nail. While we should strive to reduce preventable deaths from opioid poisoning, we would be foolish to think that was the only job that needed doing.
Well-informed consumers in partnership with smarter prescribers and allied practitioners could have better pain management with less of the carnage we currently see. Based on studies like this one, that doesn’t seem unrealistic. Most of the harm seems to come from drugs that are not particularly efficacious. It may well be that having a nationally consistent approach to persistent pain will solve several “intractable” problems at once.
Michael VaggClinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health
Chronic Pain nos. in North America are staggering ~ In 2013 Reported Nos. were 70 Million (USA) . In 2 years, nos. have reached 100 Million and rising...
TIFF 2014 ( Toronto Intl Film Festival). AWESOME time ! shopping around our new film project: Pandemic of Denial- The World Pain Crises for funding and broadcaster interest. Shown above: Toronto Director Tina Petrova and Producer Bob Schubring from Troy Michigan.
Pandemic of Denial TM ~ The World Pain Crises, is a NEW FILM in Development by Bob Schubring and Tina Petrova.
We are seeking Pain specialists, Doctors, those who treat Pain patients- to act as consultants on the film and for possible interviews. We are also interested in hearing from Pain patients about their battles with the health care system. Your information is safe with us. We will not share any information you provide without your express permission in writing.
Use our CONTACT form to reach us.
BECOME PART OF THE SOLUTION.
Every day, Im subjected to more and more disturbing stories about the growing number of pain patients in North America. Government statistics predict that in only 10 short years, with baby boomers rushing towards aged 65- 70 and retirement from the work force, 1 in 3 Americans will be living in chronic intractable pain in the coming decade. Whats worse, is that there is little to no funding in place for research for effective pain treatments. WHO will carry this societal burden ? Why isnt the Pain Epidemic mentioned in mainstream news?
A group of us- pain patients, engineers, doctors and inventors, have banded together to bring this issue to light for the general public. Recently, the news has been filled with the shameful scandal of our veterans, who fought for our freedoms, returning home to long wait lists for PTSD and other chronic pain conditions, only to find out that their benefits dont cover their badly needed therapies, or that their names go mysteriously missing off the long wait lists. Suicides are up among our countries veterans, in both Canada and the US.
What WILL WE DO ? What CAN WE DO ? We can be more vocal. We can band together- we can join forums and contact members of goverment through writing campaigns. We can tell our stories on the internet, through videos.
Stand up and be counted ! All that remains between chronic pain and a cure is us. Chronic Pain hurts everyone. Become part of the solution.
The Genesis TM hand held light unit and Light Chair TM are the latest in innovative, drug free technology in the treatment of chronic pain and inflammatory conditions.
Pictured here: Genesis light study performed on stubborn facial rash that would not resolve. After only 3 light treatments, once per day, the longstanding rash began to clear. After 7 days of light treatment, the rash resolved.
In the case of carpal tunnel, SI joint pain, low back and neck pain- 7 treatments, once dail with the light - yield cumulative positive effects in the relief of chronic intractable pain. On going treatments continue to manage longstanding pain conditions that result from inflammation. Best employed to minimize neuropathic and other pain. Can safely be used in combination with oral meds and pain injections etc. For further information, visit their website.
Pain in America- The Silver Tsunnami
is a brand new film on Pain that focuses on the natural health care
modality of Chiropractic in America.
It is scheduled to be released this fall on PBS across America.
For more info. contact : www.askdrjune.com
Chronic pain is the most misunderstood of all illnesses. A Pain patient is lucky to gain any sympathy for their potentially life long condition- which potentially will not resolve.
If one is diagnosed with cancer or any life threatening illness, friends, co workers , family rally around the patient with assistance, concern, well wishes prayers, financial help.
With a pain patient, shortly after the initial diagnoses, no one wants to hear that you are in pain. Sympathy fast diminishes . One must be careful to not mention how one is really feeling, or face losing friends and the support of family. No one wants to hear you are in pain, let alone YOU LIVE IN PAIN- as a way of life.
Perhaps society, family, friends feel threatened by the fact that they too are only one diagnoses or car accident away from a life of pain.
Perhaps we frighten their very well being and happiness, almost as if its contagious. They shudder at the thought of what that might look like for them.
Pain patients quickly learn to minimize their on going distress and discomfort, in order to receive any kind of care or support. Isnt that a sad state of affairs?
Reach out to a pain patient today. Tell them you want to hear how they REALLY are, feel. Tell them you care.
Although not able to heal, love , care and concern are balm for the weary soul. Think of this next time someone share you they live in chronic pain.