This is really offensive, not to mention ignorant

Discussion in 'Fibromyalgia Main Forum' started by PepperGirl52, Oct 29, 2006.

  1. PepperGirl52

    PepperGirl52 New Member

    OK, I'm taking a deep breath here, but this needs to be said!! I just read several posts about those who take prescription meds (especially narcotics). Those who do not, and refuse, do so because they do NOT want to become 'a drug addict' or 'addicted', etc.

    Please, people. Do not take away our dignity by calling us drug addicts if we need to take narcotics to function every day! You have NO IDEA the physical and emotional pain some of us went through to come to the place where we could even ACCEPT the fact that we would HAVE to be on narcotic pain meds, possibly for the rest of our lives!!

    There is a HUGE difference between addiction and dependence, and I'm sorry we have to beat this dead horse once again, but it looks like there are just too many people on this board who just DON'T GET IT!

    Dependence-I take my meds, as prescribed, never more, never stronger, so that I can get out of bed every freaking day, get up, act like a human being, be kind to mankind, and actually MOVE!

    Addiction-that person who is going from doc to doc or ER to ER to get this med and that med (oxycontin, dilaudid, morphine, who cares??), sells it on the streets, buys or takes more than he is given, gets high, gives others the benefit of getting high!

    See the difference?? Well, if you don't, I'm really sorry!! But I am NOT a DRUG ADDICT! I am just like you-I have a chronic illness, I am in pain EVERY DAY, rain or shine, and truth be told, I should be on even stronger meds than I am!!

    It's tough enough to have that stigma on me by the people out there in the medical field, or the pharmacist who doesn't know me, or the person behind me in line to get my meds. But to come here, where I'm supposed to feel like an EQUAL and have that thrown in my face-it's unconscionable! PG
  2. Gothbubbles

    Gothbubbles New Member

    Well said.

    People who "Don't want to take narcotics" might be people who don't suffer your kind of pain--which means they "choose" not to take them, where it sounds like you don't really have a choice.

    CFS 6 1/2 years
  3. Mikie

    Mikie Moderator

    There is so much misinformation regarding opiods and potential addiction. Addiction in those taking opiods for chronic pain is very rare except in those cases where one is already addicted to alcohol and/or drugs. I don't think those who fear addiction mean you any harm or disrespect. They are acting only from their own fears, which are not supported by the facts. Still, they have a right to make the decision not to take opiods just as we have the right to take them. I just hope that when people make these decisions they are based on good research and not irrational fear. In every case where we take any drug or use any treatment, it is our responsibility to perform due diligence to weigh the potential risks versus the potential benefits, even when the docs recommend them. I think instead of taking these things personally, perhaps we could use the opportunity to educate. Here is a copy of a post I did a while back.

    Love, Mikie

    **********************************************

    <b>Addiction Versus Dependence And Tolerance</b>

    From The National Institute On Drug Abuse 07/12/06 11:55 AM

    Even many docs cannot agree on what constitutes addiction and there seems to be a lot of confusion regarding this topic. I went to the National Institute On Drug Abuse and got some info regarding these terms. I posted this in another thread, but it's so important, in view of the fact that so many of us need pain meds and other heavy hitter medications, that I decided to give it its own post.

    Because this article is rather lengthy, I've added bold and italics where the article emphasizes the definations in question. I hope this helps when trying to make informed decisions regarding meds. Certainly, the potential for abuse, tolerance, and dependence are all germane to performing due diligence.

    Love, Mikie

    *****************************************

    <b>Definitions Related to the
    Use of Opioids for the Treatment of Pain</b>



    The American Academy of Pain Medicine, The American Pain Society and the American Society of Addiction Medicine

    Consensus Document

    BACKGROUND

    Clear terminology is necessary for effective communication regarding medical issues. Scientists, clinicians, regulators and the lay public use disparate definitions of terms related to addiction. These disparities contribute to a misunderstanding of the nature of addiction and the risk of addiction, especially in situations in which opioids are used, or are being considered for use, to manage pain. Confusion regarding the treatment of pain results in unnecessary suffering, economic burdens to society, and inappropriate adverse actions against patients and professionals.

    Many medications, including opioids, play important roles in the treatment of pain. Opioids, however, often have their utilization limited by concerns regarding misuse, addiction and possible diversion for non-medical uses.

    Many medications used in medical practice produce dependence, and some may lead to addiction in vulnerable individuals. The latter medications appear to stimulate brain reward mechanisms; these include opioids, sedatives, stimulants, anxiolytics, some muscle relaxants, and cannabinoids.

    Physical dependence, tolerance and addiction are discrete and different phenomena that are often confused. Since their clinical implications and management differ markedly, it is important that uniform definitions, based on current scientific and clinical understanding, be established in order to promote better care of patients with pain and other conditions where the use of dependence-producing drugs is appropriate, and to encourage appropriate regulatory policies and enforcement strategies.


    RECOMMENDATIONS

    The American Society of Addiction Medicine (ASAM), the American Academy of Pain Medicine (AAPM), and the American Pain Society (APS) recognize the following definitions and recommend their use:

    ADDICTION

    Addiction is a primary, chronic, neurobiologicneurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

    PHYSICAL DEPENDENCE

    Physical dependence is a state of adaptation that often includes tolerance and is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

    In the case of sedative drugs, spontaneous withdrawal may occur with continued use. Tolerance Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug's effects over time.


    DISCUSSION

    Most specialists in pain medicine and addiction medicine agree that patients treated with prolonged opioid therapy usually do develop physical dependence and sometimes develop tolerance, but do not usually develop addictive disorders. However, the actual risk is not known and probably varies with genetic predisposition, among other factors. Addiction, unlike tolerance and physical dependence, is not a predictable drug effect, but represents an idiosyncratic adverse reaction in biologically and psychosocially vulnerable individuals. Most exposures to drugs that can stimulate the brain's reward center do not produce addiction. Addiction is a primary chronic disease and exposure to drugs is only one of the etiologic factors in its development.

    Addiction in the course of opioid therapy of pain can best be assessed after the pain has been brought under adequate control, though this is not always possible. Addiction is recognized by the observation of one or more of its characteristic features: impaired control, craving and compulsive use, and continued use despite negative physical, mental and/or social consequences. An individual's behaviors that may suggest addiction sometimes are simply a reflection of unrelieved pain or other problems unrelated to addiction. Therefore, good clinical judgment must be used in determining whether the pattern of behaviors signals the presence of addiction or reflects a different issue.

    Behaviors suggestive of addiction may include: inability to take medications according to an agreed upon schedule, taking multiple doses together, frequent reports of lost or stolen prescriptions, doctor shopping, isolation from family and friends and/or use of non-prescribed psychoactive drugs in addition to prescribed medications. Other behaviors which may raise concern are the use of analgesic medications for other than analgesic effects, such as sedation, an increase in energy, a decrease in anxiety, or intoxication; non-compliance with recommended non-opioid treatments or evaluations; insistence on rapid-onset formulations/routes of administration; or reports of no relief whatsoever by any non-opioid treatments.

    Adverse consequences of addictive use of medications may include persistent sedation or intoxication due to overuse; increasing functional impairment and other medical complications; psychological manifestations such as irritability, apathy, anxiety or depression; or adverse legal, economic or social consequences. Common and expected side effects of the medications, such as constipation or sedation due to use of prescribed doses, are not viewed as adverse consequences in this context. It should be emphasized that no single event is diagnostic of addictive disorder. Rather, the diagnosis is made in response to a pattern of behavior that usually becomes obvious over time.

    Pseudoaddiction is a term which has been used to describe patient behaviors that may occur when pain is undertreated. Patients with unrelieved pain may become focused on obtaining medications, may "clock watch," and may otherwise seem inappropriately "drug seeking." Even such behaviors as illicit drug use and deception can occur in the patient's efforts to obtain relief. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when pain is effectively treated.

    Physical dependence on and tolerance to prescribed drugs do not constitute sufficient evidence of psychoactive substance use disorder or addiction. They are normal responses that often occur with the persistent use of certain medications. Physical dependence may develop with chronic use of many classes of medications. These include beta blockers, alpha-2 adrenergic agents, corticosteroids, antidepressants and other medications that are not associated with addictive disorders.

    When drugs that induce physical dependence are no longer needed, they should be carefully tapered while monitoring clinical symptoms to avoid withdrawal phenomena and such effects as rebound hyperalgesia. Such tapering, or withdrawal, of medication should not be termed detoxification. At times, anxiety and sweating can be seen in patients who are dependent on sedative drugs, such as alcohol or benzodiazepines, and who continue taking these drugs. This is usually an indication of development of tolerance, though the symptoms may be due to a return of the symptoms of an underlying anxiety disorder, due to the development of a new anxiety disorder related to drug use, or due to true withdrawal symptoms.

    A patient who is physically dependent on opioids may sometimes continue to use these despite resolution of pain only to avoid withdrawal. Such use does not necessarily reflect addiction.

    Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects. For example, in the case of opioids, tolerance usually develops more slowly to analgesia than to respiratory depression, and tolerance to the constipating effects may not occur at all. Tolerance to the analgesic effects of opioids is variable in occurrence but is never absolute; thus, no upper limit to dosage of pure opioid agonists can be established.

    Universal agreement on definitions of addiction, physical dependence and tolerance is critical to the optimization of pain treatment and the management of addictive disorders. While the definitions offered here do not constitute formal diagnostic criteria, it is hoped that they may serve as a basis for the future development of more specific, universally accepted diagnostic guidelines. The definitions and concepts that are offered here have been developed through a consensus process of the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine.


  4. PepperGirl52

    PepperGirl52 New Member

    Don't want this to be a shouting match, but I just don't think that some of us really understand. We are on the same team here!

    Please, don't make your comrades in arms feel like they are a lower notch on the limb because they 1) can't work; 2) have to take narcotics; 3) don't use herbal supplements; 4) actually LIKE their docs; etc.

    Sometimes I come here, and just want to zone out with others who can feel my pain. Then I read posts like that, and it just upsets me to the point that I feel that NO ONE understands!! Not even those who share this horrid disease with me.

    And yes, I DO have other issues. As I mentioned in another post, I have had 3 major spinal surgeris in the past 4 years. So, even without the fibro, I would be in pain. But add your fibro to MY spinal problems, and think of the pain that a person could have. NOT FUN AT ALL!

    I want to be able to come here and find solace. But, wow-didn't happen tonight!
  5. ABLUV

    ABLUV New Member

    Pepper, I apologize for those who have hurt you with their
    comments. Please know that everyone does not feel that way
    about you. I feel that you must do the best you can to get
    the best quality of life possible in spite of the horrible
    pain you suffer. If prescription meds, even narcotics is what it takes, who am I to judge? I don't believe that God
    frowns upon it unless a person is like the addict you described in your post, so I don't judge either. I feel it
    is so sad when people lack compassion just because everyone
    doesn't face illness and life's troubles the same way they do.

    Whatever you do, don't let those comments keep you away from the people who will offer you good information, comfort and encouragement. I, for one, am on your side...

    love & prayers,
    abluv
  6. homesheba

    homesheba New Member

    because i get that kind of talk at home also...
    no matter if i was laying on the floor with my arm cut off and needing a pin pill-
    they would say- ' you will get addicted...
    you can do without it..
    . or ill get' the look'...
    i am 52 years old,
    living with my mom now and dh and
    believe me...
    i would need alot more drugs
    than what i have now to be an addict...
    my pitiful dr
    cant seem to get past lortab and vicodin...grrr!!!
  7. lenasvn

    lenasvn New Member

    Did someone here on the board get on your case personally? If so, I am really sorry. I have not been reading as much as usual on the board and must have missed what happened.

    I just wanted to sen you a fibrohug!!

    Lena
  8. onedaymagpie

    onedaymagpie New Member

    Hi Pepper
    I don't know if this is true, but I have read more than one place that when someone is in paid and taking pain meds, they don't feel the "high" that someone who is not is pain will feel if they take the pain meds - so the issue of addiction or abuse for one in pain is completely different. Makes sense to me. Of course, all of us would rather not need any meds, but thus is this DD . . .
  9. victoria

    victoria New Member

    -- people in general, including/especially doctors, don't know what real pain is until they experience it themselves. Until and unless they do, they have no idea (at least 99.9% of them).

    I have seen dramatic differences firstly in attitude but even more especially in doctors' willingness to RX narcotic painkillers once the doctor him/herself experiences chronic debilitating pain firsthand.

    I have also seen closeup the difference between physiologic dependence/addiction to something and psychological addiction.

    If physiologic addiction/dependence is considered to be the same as psychological, then all antidepressants (ADs) should be considered narcotics!

    ... one has to wean off these as well, after all, because if one stops ADs abruptly, there is a huge price to pay both physically and mentally.

    all the best,
    Victoria




    [This Message was Edited on 10/29/2006]
  10. findmind

    findmind New Member

    Girl, you know we love and support you here...the ignorant must be forgiven, the stupid overlooked, ok?

    Don't even give those types of people the time of day. We who DO walk in your shoes know exactly what you mean and want you to come here and share with us who do understand.

    Just move on past the others...

    We looooooove you!
    findmind
  11. Mikie

    Mikie Moderator

    I just took a few minutes to read through the booklet I received from the hosp. where I will be having my surgery and here is part of the section on pain.

    "You have the right to: Be educated about pain and pain relief measures; Have any reports of pain accepted and acted on by healthcare professionals; Have pain evaluated frequently; Have pain treated; or, Refuse pain management treatment."

    Then, they included info on Myths versus Facts:

    "<u>Some Facts You Should Know</u>

    Many people are reluctant to discuss their pain for several reasons:

    MYTH: 'I should expect pain because I'm in the hospital.'
    FACT: Today, controlling pain is a very important part of a hospital's care of patients.

    MYTH: 'If I take pain medicines (such as narcotics or opiods) regularly, I will be hooked or addicted.'
    FACT: Addiction is very rare in patients without a history of drug/alcohol abuse when taking pain medicines under a doctor's care.

    MYTH: 'The side effects of pain medicines will make me sick.'
    FACT: As health care professionals, we are trained to recognize and manage any side effects related to pain medications."

    Thought this info right from "the horse's mouth" might be helpful for those considering pain meds. It's OK to take them and it's OK to choose not to. We are all in the same boat; we just use different kinds of oars. We needn't agree on every aspect of treatments but we need to support one another.

    Nancy, thank you so much for your kind words. This issue is near and dear to my heart. Before I got FMS, I would have never believed I would take an opiod, let alone Morphine. I lucked out and got a good pain specialist and I got educated about pain management.

    Love, Mikie
  12. ladykew

    ladykew New Member

    Thank you, Pepper, for speaking for all of us who experience the same thing day in and day out. Is it not enough that we have to take narcotics to help control our pain stemmed from a chronic illness or (illnesses) and still be in pain? And then to be labeled or talked about?

    Yes, it's tough to have that stigma put on me. But listen up, folks, no body knows what my body has gone through. Those of you who are fortunate enough to go through life without being on narcotic pain medications, I'm happy for you. I'd rather not have reason to have to take them.

    Best of health!
    Lew
  13. 1sweetie

    1sweetie New Member

    I'm glad I haven't read the post you are speaking about or I would be writing this thread.

    Until someone has walked in your shoes, they can not understand. I have to take medications. Without them I do not function.

    Those that would write something like that are ...I'm looking for a better word than ignorant but I can't think of one now.

    You do what you have to do to survive and take good care of yourself. I and many more support your decision and our decision to do what we have to do and the others do not count.
  14. rosemarie

    rosemarie Member


    I hope that my posts about my reading my medical history and how it made me feel was not the cause of your distress. I have struggled with family , friends, and now I had learned that my doctor a man who I thought of as a good friend felt as if I was taking too many pain pills. This was a shock to me and it upset me. I am the person who is needing to accept myself for who I am now.

    Going thru life that has been filled with pain is hard.And it is hard to accept yourslef for taking the pain medicaitons that a doctor has given you when all you hear on the news and from family ,friends, and sometimes other doctors that because your taking such strong narcotic pain pills that you must be adddcited to them.

    I didn't mean to cause any problems or to make any one feel bad and upset. IF during my post where I was sorting out my life and accetping my self , I said some thing that upset you or caused you pain I am so sorry . It was not my intent to do so.

    I know that for me I will need to be on pain meds for my life time and I do take them like they have been perscribed for me. This does not make me an addict . Just a person who has a illness who requires daily medicaions that just happen to be narcotic pain meds.

    So if in any of my posts I have written any thing that was upsetting to you or any one else I am truely sorry as I didn't mean to do so. I was just explaining my story and how I felt about it. But I didn't mean to cause and hurt feelings. I am so sorry if this happened.

    HUGS,
    Rosemarie

  15. joyfully

    joyfully New Member

    Wow, what a good topic! I happen to be someone who normally doesn't take pain medications. I have severe rheumatoid arthritis and fibromyalgia. The reason that I don't take pain medications is that it hurts too much when they wear off. I know that probably sounds whacky, but I've had RA since I was 18 months old. I'm almost 60 years old now.

    I think of pain as my helper. it tells me when I'm overusing my arthritic joints. It tells me when I need to rest.

    I do take a pain pill if I'm going to have a painful medical procedure (and I know about it ahead of time).

    Because I've lived with chronic pain since I was an infant, I sometimes don't recognize the quantity of pain that I'm actually experiencing. I will just get cranky, or I will have a hard time comprehending instructions. It is like my brain disconnects to cope. My husband can recognize if I'm in acute pain before I do. He will request that the nurses give me pain medication. I will still be denying the pain. Then, after I get the pain medication, I will realize how much pain I was actually experiencing.

    I'm glad that you brought up this subject. I have injections in my spine at a pain management clinic. They also do nerve blocks on my spine. When they offer to write me a RX for pain medication after the procedure, I normally tell them "no". Additional patients can hear my conversation because there are only curtains between the patients in the recovery area. I will be sure to not add any comments after the "no" ---except the words "thank you".

    I really don't know if I make a statement about pain meds in front of other patients. I will be sure to check myself from now on.

    Everyone is correct here. You REALLY don't know how badly someone else is hurting. Everyone has a different tolerance for pain too. I find that if I'm stressed, my pain level increases.

    This is a very relevant topic. I'm really glad that you posted it. We can all learn to not be judgemental---no matter the topic.
  16. Liz919

    Liz919 New Member

    I'm going to go ahead and apoligize for everyone who isn't taking meds who made you feel this way. I don't take meds...because I'm not in the amount of pain you're in anymore. It's not because I don't want to be addicted, though lord knows that would be bad, but because I am blessed in that I don't need to. If other people have found their miracle treatment and it's not a drug then I am very happy for them, but that doesn't give them ANY right to put you down because what works for you is engineered in a lab instead of by mother nature. God helps those who help themselves not those who sit around and wait for miracles from out of nowhere. I'm not sure if I'm wording this right but the point is that you're not a bad person for doing what you need to do to survive. The people who aren't doing what they should are the people who are being stuck up and mean when they're supposed to be using this forum as a venue of support for all of us. I hope you feel better and the all the Meanies leave you in peace. Big eHugs!
  17. hugs4evry1

    hugs4evry1 New Member

    I don't often read the pain threads because at the moment, I'm not in very much pain.

    So I read this thread with interest and wondered who in the world would do that to someone on this board and yet I see it again for myself.

    I'm so sorry that a few people on this board would say things that either could or did make you feel bad about the meds you are taking.

    I can't imagine having spinal pain on top of what we go through with fibro, which is plenty by itself! If meds help you to get through the day, then I truly hope they work for you.

    I often think that people don't understand how serious this illness can get, unfortunately I'm pretty sure that someday they'll understand too.

    Hugs,

    Nancy B
  18. evol_or_revert

    evol_or_revert New Member

    Thanks for getting it out there.
  19. PepperGirl52

    PepperGirl52 New Member

    I need to apologize for making it sound like it was a personal attack at ME, and that it was one personal poster. It was not.

    It was during my reading posts off and on here today that I ran upon a common thread. And that's what brought me to the point of writing this post.

    I appreciate your comments more than you know, and for those of you who even apologized, please-don't ever let my blowing off steam be in your top 10 reasons to lose sleep!

    The main thread of THIS post is that we are all very different, have different levels of pain, and we ARE a unit, fighting this ugly disease together!! Whether we have relatives, doctors, or whoever not believing us, not trusting us, or making us feel guilty for whatever-we all seem to have that in common as well. What a shame!!

    Just knowing that we are not alone is the point of this board-at least that's how I feel, and why I've stayed here for the past 2 years. It's the best group therapy I can get for free, that's for sure!!

    I just think, every now and then, we get new people, or uninformed people, who just don't understand. And that's where we 'oldies' come in. I, too, apologize for taking it in a different direction than it should have possibly gone. But I do think it needed to be mentioned. Thanks to all of you for your responses! PG
  20. victoria

    victoria New Member

    From
    The Tragedy of Needless Pain
    by Ronald Melzack; Scientific American; 262(2); February 1990.

    "Pain" as Albert Schweitzer once said, "is a more terrible lord of mankind than even death itself." Prolonged pain destroys the quality of life. It can erode the will to live, at times driving people to suicide. The physical effects are equally profound. Severe, persistent pain can impair sleep and appetite, thereby producing fatigue and reducing the availability of nutrients to organs. It may thus impede recovery from illness or injury and, in weakened or elderly patients, may make the difference between life and death....

    Studies of patients who received narcotics while they were hospitalized have . . . uncovered little evidence of addiction. In an extensive study Jane B. Porter and Hershel Jick of the Boston University Medical Center followed up on 11,882 patients who were given narcotics to relieve pain stemming from various medical problems; none of the subjects had a history of drug dependence. The team found that only FOUR of the patients subsequently abused drugs, and in only one case was the abuse considered major.

    Equally persuasive are the results of a survey of more than 10,000 burn victims. These individuals, who were studied by Samuel W. Perry of New York Hospital and George Heidrich of the University of Wisconsin at Madisom underwent debridement, an extremely painful procedure in which the dead tissue is removed from burned skin. Most of the patients received injections of narcotics for weeks or even months. Yet not a single case of later addiction could be attributed to the narcotics given for pain relief during the hospital stay. Although 22 patients abused drugs after they were discharged, all of them had a history of drug abuse.

    Further evidence that narcotic drugs can be administered for pain without causing addiction comes from studies of "patient-controlled analgesia" in surgical patients and those hospitalized for bums. In such studies patients push a button on an electronically controlled pump at the bedside to give themselves small doses of morphine (through an intravenous tube).

    When these devices were introduced, there was considerable fear that patients would abuse the drug. Instead it soon became clear that patients maintain their doses at a reasonable level and decrease them when their pain diminishes.

    Studies that explore how morphine produces analgesia are helping to explain why patients who take the drug solely to relieve pain are unlikely to develop rapid tolerance and become addicted.

    On the basis of such studies, my former student Frances V. Abbott and I proposed in 1981 that morphine probably has an effect on two distinct pain-signaling systems in the central nervous system and that one of these - which gives rise to the kind of pain typically treated with morphine - does not develop much tolerance to the drug.

    ---------------------------------------
    The following are excerpts from an article appearing in
    NEW SCIENTIST magazine on April 6, 1996.

    by Rita Carter

    Doctors' reluctance to prescribe morphine centres on a trio of enduring myths, say pain experts. The first is that morphine, even when used as an analgesic, is addictive. The second is that the dose has to be continuously increased to maintain the same effect. The third is that narcotics used for pain relief can hasten death.

    These beliefs are widely held by doctors, nurses, patients and governments, even though they were debunked long ago.

    MINIMAL RISK:
    "It hardly matters if a person on the brink of death becomes addicted," says Mike Harmer, senior lecturer in anaesthesia at the University of Wales College of Medicine. "But even if it did, I would say the risk is practically nil. We sometimes give patients in severe pain massive doses of narcotic - sixty or seventy times the usual amount. When the pain subsides they turn down the next dose you offer, walk away, and that's it."

    A paper in The New England Journal of Medicine in 1980 revealed that the risk of creating addiction in a patient treated with morphine for pain relief is about 1 in 3,000.

    Healthy people who take morphine for recreational purposes, however, are much more likely to become addicted. This is because narcotics work differently on people in pain. Patrick Wall, one of Britain's leading pain specialists at University College London, believes the condition brings about a change in the brain which causes morphine to be "mopped up" in a way that does not happen with healthy people.

    "If you give morphine for the first time to someone who is not in pain they will feel nauseous and headachy," he says. "These side effects are quite rare in people in pain - the pain itself seems to protect them against most of the undesirable actions of the drug, including the ability to induce addiction."

    Wall also dismisses the second myth - that it must be given in increasing doses. He claims that if morphine is being used for pain relief "there is no need to up the dose unless the pain gets worse".

    The most potent and widespread myth of all - that medicinal morphine can cause early death - is also largely groundless, according to Harmer. He claims a fairly small dose could kill a person who is not in pain, but that with someone in chronic pain who has been taking morphine for some time "you can pump the stuff in almost without limit and not do them any harm . . . If anything, opiates will lengthen a terminal patient's life, because pain relief will allow them to eat, sleep and function better."

    For the past two decades these findings have been trumpeted by pain specialists, the hospice movement and the WHO. . .

    Even when doctors are not hampered by prejudice about narcotics, their patients often are. A Gallup Poll carried out in 1994 found that one in two adults would not want to take opiates for pain relief, even if they badly needed them.

    --------------

    By the way, Melzack and Wall were very famous for creating the gate theory of pain...

    [This Message was Edited on 10/29/2006]