The Good/Bad News re Pain Opiod Meds

Discussion in 'Fibromyalgia Main Forum' started by victoria, Jan 24, 2010.

  1. victoria

    victoria New Member

    This is good research (replicating prior research) showing that the main excuse (fear of addiction) to not RX opiod pain meds is not a good one. I hope this will be convincing to some doctors who need a push. (absolutely no pun intended either, yikes)

    (I posted this last week, and was going to bump it, but accidentally deleted it)

    Little Risk for Addiction From Long-Term Opioid Use in Select Chronic Pain Patients

    Pam Harrison

    January 20, 2010 — Long-term opioid therapy is associated with little risk for addiction when given to selected patients with chronic noncancer pain (CNCP) and no history of substance addiction or abuse, according to a review published online in the January issue of The Cochrane Library.

    Meredith Noble, MS, ECRI Institute, Plymouth Meeting, Pennsylvania, and colleagues found that only 7 (0.27%) of 2613 patients in the studies reviewed who received opioids for CNCP for at least 6 months reportedly developed an addiction to the medication or took the medication inappropriately. Most of the participants in the reviewed clinical trials had chronic back pain after failed surgery, severe osteoarthritis, or neuropathic pain.

    Importantly, however, a significant percentage of patients taking opioids in any form, but especially oral formulations, withdrew from the study because of adverse effects or insufficient pain relief.

    "I think one of the most important things to note is that patients in this review were screened for any history of addiction, so findings may not be applicable to the population as a whole or to people with substance misuse problems," Ms. Noble told Medscape Psychiatry. "But the most important message about this review is that we still don’t have an answer for many people living with chronic pain."

    (rest of article at above url)

    I have seen a terminal cancer friend denied opiods in the hospital for "fear of addiction" only 15 years ago, even tho he had only days left...

    (if only he had been in hospice, there is often a real disconnect)

    (and even tho he was an MD, his wife an RN, and 2 kids were MDs)

    all the best,

  2. TeaBisqit

    TeaBisqit Member

    I've heard it so much from docs over the years. They never want to give me anything real because they are afraid of addicting me. And I get so annoyed, I'm like, come on, what's worse at this point, to leave me in pain every day or to give me something that could take that pain away.

    I really don't want to get addicted to anything. Those withdrawals are scary looking.

    I just want something that works on this pain and won't make me worse or sleepy. Haven't found it yet.

    It reminds me of that old Huey Lewis song, I Need a New Drug.
  3. hermitlady

    hermitlady Member

    Unfortunately many Drs are not following this philosophy and let their patients suffer needlessly. Narcotic pain meds often make a drastic improvement on our QOL. I know I was pleasantly surprised at how much better I felt when I started w Vicodin.

    The "addiction" problem isn't necessarily addiction, it's a dependence that your body has on the meds. And unfortunately, a tolerance is also built up so we need to increase dosages. I'm living proof, I've been on opioids for 3+yrs and now weaning off to take a holiday and reassess my pain. It's no fun, but pain isn't any fun either!

    I think Drs are also closely watched these days by drug enforcement officials. I know my Dr has told me about things he goes thru to stand up for chronic pain patients who are on long term narcotics. Unfortunately, the stigma surrounding their use is very prominent these days (w all the "celebrities" that have OD'd in the public eye).
  4. hermitlady

    hermitlady Member doc told me to take Miralax 3x a wk for the const. issue. Works great and you can't even taste it when mixed into juice or other drinks.
  5. victoria

    victoria New Member

    there's 2 kinds of 'addiction' - physiological which many drugs create including psychotropics, even those have to be dropped slowly if one is going to stop it; and psychological. I don't really want to get into it all here, as it's been discussed to death here in prior years.

    But I've had friends who needed morphine on a regular basis to deal with FM pain.... and I know some who have been totally denied any kind of pain med. So much depends on the doctor. And the pharmacists, who will often report RXs they don't think is necessary and some go too far. i have seen both sides...

    And of course no matter what one takes or doesn't, there's always side effects and if one can handle them or not.

    Constant pain lowers one's immune threshold for one because of the stress besides driving you over the edge, OTC painkillers can cause ulcers, narcotics can cause severe constipation (I know cuz I ended up in the hospital ER with it - TG for morphine so I could get out of the foetal position) (tho now perhaps preventive meds might help - but that was the problem, I thought everything was normal until it all 'seized up")....