Saturday, May 10, 2008

Pain Medication Does Not Lead to High Risk of Addiction

Using strong pain medications, including opioids, for long-term, chronic pain puts you at high risk of addiction, RIGHT? Srinivasa Raja, MD, a professor of anesthesiology at Johns Hopkins University Medical School says that is WRONG.

Raja presented the lecture: From Poppies to Pill Popping: Is There a "Middle Way"? at the
27th Annual Scientific Meeting of the American Pain Society (APS) Raja reported that less than 3% of all chronic pain sufferers, with no history of drug abuse of any kind, will show signs of abuse or dependence. He urged clinicians not to allow this small percentage to prevent them from prescribing pain medications to patients who are more likely to benefit from them than be hurt by them. Raja also said:
We also are dealing with unfounded accusations in the media that increased prescribing of opioids for severe chronic pain is responsible in large part for reported upswings in the abuse of pain medications
Raja stressed the importance of communication between doctor and patient, the importance of patient monitoring to identify addictive behavior, and the importance of monitoring patients to see if doses can be lowered as pain control improves. He also suggests alternative treatments such as cognitive behavior and physical therapy to supplement pain medication whenever possible.

His lecture asked federal and state regulatory agencies to aim for state-to-state consistency in regulating controlled substances and called for a crack down on illegal internet pharmacies and prescription thefts and forgeries. He applauded teen drug awareness campaigns as a means of preventing this type of drug abuse. Raja's also had a message to the pharmaceutical industry and said:

the key challenge is to match clinical needs for less addicting pain medication with drug development priorities. “There are novel analgesic formulations in various stages of development that we hope can be prioritized and expedited for clinical use
Raja cited two outdated beliefs about pain that were later disproved by scientific evidence. The first, a commentary published in the Journal of the American Medical Association fifty years ago that said cancer patients shouldn't use opioids due to the possible risk of addiction and secondly, the belief, twenty years ago, that infants shouldn't receive anesthesia because they didn’t feel pain. Both beliefs are now abandoned and Raja feels that the fear of addiction in pain management should be abandoned too.

sources: Chronic Pain Meds Unlikely to Cause Addiction and Risks for painkiller abuse do not outweigh benefits in chronic pain


Jerry said...

You have a nice blog. I have lived in chronic pain for 20 years and have been fighting the system for the last 10 years. I read this same article you are talking about. I don't know what people in chronic pain are going to do, but nothing is going to happen until the general public, and the medical profession get educated on chronic pain, the DEA gets out of the medical business and the damn politicans make some new laws. what is going on in America today with the chronic pain patient is nothing less than genocide. Visit my blog sometimes.

Pam said...

Thanks Jerry! The DEA is all mixed up in all this. We've got doctors that know what they're doing but their hands are tied and they can't do what they were educated to do...because they're scared of the DEA. We've got doctors that graduated at the bottom of their class dispensing opioids as if they were candy and never get caught. And we've got the DEA themselves, wanting you to think that a doctor who prescribes opioids for his patients is a drug dealer and is only in business to get you addicted. When you finally go to the ER because you can't stand the pain for one more second, Dr. Goodie Two Shoes, who, by the way, is either owned by an HMO or Big Pharma is standing in the entrance wearing his bada*s sh*tkickers. One word out of your mouth and he's labeling you as a drug seeker while booting you out the door.

To top it all off, you finally find a medication that allows you to function like a normal human being in 10 minute increments, to make your kid a peanut butter and jelly sandwich, take a shower, cook dinner or wash a dish and what happens? Your insurance company refuses to pay for it because you are only entitled to pain relief if you dying of cancer.

Migraine Chick said...

Thank you for posting about this. I wish the general public and the DEA would get a clue so we can get some decent pain relief.

Love your blog!

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