Amy Winehouse is Dead

[LoALAnna]

Here is another opinion from the peanut gallery: Many times an addiction can develop from doctor prescribed medications. I really believe that many, if not most drug addictions stem from pain killers and the body's tolerance to them if taken for a long time. After a while the prescribed amount does no good and an alternate/self medication is sought. I hope that all the rigid, intolerant and un-empathetic folks out there never have an illness or injury that requires long-term medication for pain. Thats all.

[capt_noonie]

Originally Posted by LoALAnna

Here is another opinion from the peanut gallery: Many times an addiction can develop from doctor prescribed medications. I really believe that many, if not most drug addictions stem from pain killers and the body's tolerance to them if taken for a long time. After a while the prescribed amount does no good and an alternate/self medication is sought. I hope that all the rigid, intolerant and un-empathetic folks out there never have an illness or injury that requires long-term medication for pain. Thats all.

[Rhetts_mama]

Originally Posted by LoALAnna

Here is another opinion from the peanut gallery: Many times an addiction can develop from doctor prescribed medications. I really believe that many, if not most drug addictions stem from pain killers and the body's tolerance to them if taken for a long time. After a while the prescribed amount does no good and an alternate/self medication is sought. I hope that all the rigid, intolerant and un-empathetic folks out there never have an illness or injury that requires long-term medication for pain. Thats all.

I'm going to disagree with that one. As someone who has suffered with chronic pain, I know first hand the stigma that comes with taking narcotics. But there have been MULTIPLE studies that show the brain of someone who takes the medication for pain as prescribed do not become addicted. The problems occur when people start taking either more than prescribed or continue taking them when they aren't needed. Self medication is not a normal nor expected outcome of someone being treated properly for pain control.

[LoALAnna]

Originally Posted by Rhetts_mama

I'm going to disagree with that one. As someone who has suffered with chronic pain, I know first hand the stigma that comes with taking narcotics. But there have been MULTIPLE studies that show the brain of someone who takes the medication for pain as prescribed do not become addicted. The problems occur when people start taking either more than prescribed or continue taking them when they aren't needed. Self medication is not a normal nor expected outcome of someone being treated properly for pain control.

My question is: How is it YOU (generally speaking) know when a pain med is not needed, especially when the person in question has chronic ongoing pain, and even surgery (back, for example) has not helped? There has been documented cases that in the U.S., especially,where doctors are afraid to prescribe the strength needed by the individual patient(due to regulations, etc.) to relieve the pain, and so the patient sometimes has no choice but to supplement just to get some sort of relief and semblance of a "normal" life.

[MaddiesMommie]

Originally Posted by LoALAnna

Here is another opinion from the peanut gallery: Many times an addiction can develop from doctor prescribed medications. I really believe that many, if not most drug addictions stem from pain killers and the body's tolerance to them if taken for a long time. After a while the prescribed amount does no good and an alternate/self medication is sought. I hope that all the rigid, intolerant and un-empathetic folks out there never have an illness or injury that requires long-term medication for pain. Thats all.

A man I know suffers with chronic pain from a work related back injury. He is now almost totally dependanat on others to do daily routines for him. He was prescibed pain medication and has not, even almost 9 years later, been able to function daily life without his medication. He is on a much higher dosage than originally prescribed becuase he began having pain while on the medication. He admits he is adicted but simply cannot deal with the pain/discomfort without them.

It is very sad to see someone suffer with addiction whether or not they "chose" to take that first dose.

[Rhetts_mama]

Originally Posted by LoALAnna

My question is: How is it YOU (generally speaking) know when a pain med is not needed, especially when the person in question has chronic ongoing pain, and even surgery (back, for example) has not helped? There has been documented cases that in the U.S., especially,where doctors are afraid to prescribe the strength needed by the individual patient(due to regulations, etc.) to relieve the pain, and so the patient sometimes has no choice but to supplement just to get some sort of relief and semblance of a "normal" life.

Let's first decipher what you mean by "supplementing". Is this a person who is taking more than one drug prescribed by a single doctor? That can be a normal course of treatment because some medications work better in combination than they do separately. Are they supplementing by taking more of a prescription drug than is prescribed? More usually isn't better in terms of pain relief, and in most cases it's more dangerous. Are they taking it in a way inconsistent with the intended method of delivery (snorting crushed tablets, for example)? That's addiction and not pain relief. Addiction increases the perception of pain that is out of proportion with the stimulus.

What you are describing (in the example you gave) is someone who's pain may be uncontrolled. That's not the same as someone who is addicted, though many of the same behaviors may present in both. It's also important to differentiate between someone who is drug addicted (which means they are taking the drugs because they have an overwhelming, compulsive, uncontrollable need to take a drug for a reason other than they were prescribed or in a manner inconsistent with the labeling) versus drug dependent (which is someone who is using the medication as intended, but has a physical dependency on the medication to function normally). While addicts may also have a physical dependency, not all people who are physically dependent are addicts. The treatments and prognosis for the two are very, very different.

While every patient responds and perceives pain differently, we (generically speaking) have some good physiologic measures for differentiating pain. Pain relief is an art, and this is where having one consistent care provider becomes essential. Too often, patients "doctor shop", getting a few meds here and a few there. When they do that, the primary doctor does not have a good over view of how severe a patient perceives their pain to be or how they perceive it affects their life. This has led to many doctors to severely limit the way they treat pain because of the potential for the abuse of the medications they prescribe. Yes, some doctors are loathe to increase the amount of a drug to the level the patient feels is necessary, some due to regulations, but most due to the risk of side effects that come in to play with the higher doses.

All pain is not the same, consequently there is no generic pain medication or dosage for a certain condition. A good provider does in-depth interviews and exams to determine things like the location, duration, aggravating and mitigating factors and the quality of the pain (does it burn,cramp, tingle... does it radiate,etc) Surprisingly,while narcotics are often found to be better for acute (right around the time of the injury/surgery), pain while medications like Lyrica (which is an anti-epileptic drug) and Cymbalta (which is an MAOI) are being used successfully in chronic pain because they seem to do a better job of interrupting the pain signals. There are also a lot of non-pharmacological interventions that have great affect on chronic pain (like spinal cord stimulators and nerve ablations). Often times, all it takes is a change in medication to one that treats the underlying condition to attain adequate pain relief.

It's a fine line to determine whether someone is self-medicating due to improper pain management versus someone who is self-medicating because they are exhibiting addictive behaviors. It's not fair nor accurate to state that it's the pain medication that made the person addicted (remember, dependency is not the same as addiction) Rather, it's the behaviors around the treatment of pain that are more likely to cause the addiction. I would go so far as to say that a person ALWAYS has a choice in whether they choose to "supplement" in a way that's unhealthy.

[Rhetts_mama]

Originally Posted by MaddiesMommie

A man I know suffers with chronic pain from a work related back injury. He is now almost totally dependanat on others to do daily routines for him. He was prescibed pain medication and has not, even almost 9 years later, been able to function daily life without his medication. He is on a much higher dosage than originally prescribed becuase he began having pain while on the medication. He admits he is adicted but simply cannot deal with the pain/discomfort without them.

It is very sad to see someone suffer with addiction whether or not they "chose" to take that first dose.

Again, there is a big difference between someone who is drug dependent and drug addicted.

[sugarmamma]

Originally Posted by Rhetts_mama

Again, there is a big difference between someone who is drug dependent and drug addicted.

I see it as a slim rope to walk. There is a very fine line between dependent and addicted, and even that fine line is sometimes blurred.

[MaddiesMommie]

Originally Posted by sugarmamma

I see it as a slim rope to walk. There is a very fine line between dependent and addicted, and even that fine line is sometimes blurred.

I agree. My BIL battled addiction however, he felt that he was unable to function without them. He was young and started taking pills as a stupid social activity. Pretty soon, daily life was just easier with a pill here and there. In his tainted mind, he was not able to deal with the pain he experienced from withdraws and the crash he felt for days after coming off the medication.

Thankfully, with rehabilitations and counseling he is recovering but it is a daily battle for him and probably always will be.

I think everyone's story is deifferent as is their circumstance. Too many in my family have dealt with addiction that started one way or another. Whether the pain is really what keeps them on medication or just the high they are used to makes it easier to deal with life, I don't know. Each person I know has a different story/excuse for continuing their medicaton. I have dealt with my own "addictions"; overeating, overspending. Both of these have impacted my life in ways that were harmful, for my health and my finacial stability. Both of these have also been responsible for the loss of life before. Again, I think it is sad to see anyone dealing with an addiciton. To have something take over your life and be in control is scary.

[MaddiesMommie]

Originally Posted by Rhetts_mama

I would go so far as to say that a person ALWAYS has a choice in whether they choose to "supplement" in a way that's unhealthy.

me too. Each person I know made the choice to seek alternative ways of getting thier drugs after their prescription was out or adding to thier presciption in order to achieve a greater relief.

[MaddiesMommie]

Originally Posted by Rhetts_mama

Again, there is a big difference between someone who is drug dependent and drug addicted.

I agree.
I feel I cannot assume whether someone is pain dependant or addicted. He was not always so dependant. After the loss of his job, car, and faced forclosure on him home, it appeared that he simply gave up. Spent most hours at home or in the the bed and made the choice to seek out ways to get the pain management he needed. Whether it is that he is REALLY dependant or addicted, either way it is sad to see.

[chachi]

Originally Posted by LoALAnna

My question is: How is it YOU (generally speaking) know when a pain med is not needed, especially when the person in question has chronic ongoing pain, and even surgery (back, for example) has not helped? There has been documented cases that in the U.S., especially,where doctors are afraid to prescribe the strength needed by the individual patient(due to regulations, etc.) to relieve the pain, and so the patient sometimes has no choice but to supplement just to get some sort of relief and semblance of a "normal" life.

This is so true and Im going through it right now. I have pain with a nerve in my leg and my doctor will only give me a little bit of pain meds not a full prescription and the pain med is not even strong enough to help me. I agree with those that say there is no difference in alcoholism, drug problem, over eating or smoking they are all addictions

[Rhetts_mama]

Originally Posted by chachi

This is so true and Im going through it right now. I have pain with a nerve in my leg and my doctor will only give me a little bit of pain meds not a full prescription and the pain med is not even strong enough to help me. I agree with those that say there is no difference in alcoholism, drug problem, over eating or smoking they are all addictions

Have you asked for a referral to a pain specialist? If you can, look for one that staffs anesthesiologists as part of their practice. Nerve mediated pain is the most difficult to treat effectively. It's the same thing I have. I had my radial nerve accidentally severed during a hand surgery that developed in to full blown reflexive sympathetic disorder. Nerve pain is one of those situations that often responds better to non-narcotic medication like the two examples I gave earlier because those medications actually change the way the nerves conduct signals. Most general practice docs and surgeons aren't familiar enough with the latest pain research to know how to prescribe them effectively for nerve pain.

[chachi]

Originally Posted by Rhetts_mama

Have you asked for a referral to a pain specialist? If you can, look for one that staffs anesthesiologists as part of their practice. Nerve mediated pain is the most difficult to treat effectively. It's the same thing I have. I had my radial nerve accidentally severed during a hand surgery that developed in to full blown reflexive sympathetic disorder. Nerve pain is one of those situations that often responds better to non-narcotic medication like the two examples I gave earlier because those medications actually change the way the nerves conduct signals. Most general practice docs and surgeons aren't familiar enough with the latest pain research to know how to prescribe them effectively for nerve pain.

No I havent because My pain is sporatic and It just started getting real bad to where I couldnt stand or walk sometimes. I did go though some testing at the hospital neurology but I havent been back at my PCP yet to get the results.

[Nancy1999]

Originally Posted by chachi

No I havent because My pain is sporatic and It just started getting real bad to where I couldnt stand or walk sometimes. I did go though some testing at the hospital neurology but I havent been back at my PCP yet to get the results.

So sorry to hear this, I hope you find some relief.